Intraperitoneal cerebrospinal fluid pseudocyst. A rare complication of ventriculoperitoneal shunt.
The abdominal intraperitoneal cerebrospinal fluid pseudocyst is a rare but important complication in patients with ventriculoperitoneal shunts. We report a case of a 31-year-old female, in which a large abdominal pseudocyst was developed 1 year after insertion of a ventriculoperitoneal shunt for hydrocephalus. The abdominal CT scan and the ultrasonographical evaluation of the abdomen showed a well defined, cystic mass lesion with a volume of 50 cm3, in the recessus hepato-renal. The peritoneal tip of the shunt was located within the mass lesion. A distal externalization of the peritoneal catheter without excision of the pseudocyst was performed. Cerebrospinal fluid culture demonstrated a Staphylococcus epidermis infection and adequate antibiotic treatment was administrated. The previous symptoms improved 4 weeks later and a new catheter was placed intraperitoneally in a different quadrant. The postoperative course was uneventful. We suggest that chronic inflammation or subclinical peritonitis is a predisposing factor for this complication.
Birbilis
Th
T
Department of Neurosurgery, University Hospital of Alexandroupolis, Democritus University of Thrace Medical School, Alexandroupolis, Greece. mpirmpil@otenet.gr
Kontogianidis
K
K
Matis
G
G
Theodoropoulou
E
E
Efremidou
E
E
Argyropoulou
P
P
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003560:Cysts / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D010529:Peritoneal Cavity / Q000601:surgery; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013212:Staphylococcus epidermidis / Q000302:isolation & purification*; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*
D000900:Anti-Bacterial Agents