CSF liver pseudocyst as a complication of a ventriculoperitoneal shunt.
We have a 30-year-old female patient suffering from secondary hydrocephalus. She has had a ventriculoperitoneal shunt (VPS) implanted following a rupture and a successful clipping of the aneurysm of the anterior communicating artery (ACoA). Three weeks after implanting of the VPS, respiratory and abdominal difficulties with febrility appeared. We diagnosed cerebrospinal fluid liver pseudocyst using ultrasound (US) and computer tomography scan (CT). Given that we found bacteria in the cerebrospinal fluid (CSF), we converted VPS into an external ventricular drain (EVD). After that, we conducted a US-guided punction and drainage of the CSF liver pseudocyst. The subsequent CT of abdomen showed a regression of the cystic form. The patient died following the septic condition with multiple organ failures (MOF) a month after the cerebrospinal fluid liver pseudocyst diagnosis.The perforation of parenhimatose abdominal organs with distal part of VPS is a rare complication which is most likely a consequence of a shunt infection and of an immunological reaction that took place during the process of localizing an infection.
Department of Neurosurgery, University Hospital of Rijeka, Rijeka, Croatia.
Zlatko
Z
Kolić
Melita
M
Kukuljan
David
D
Bonifačić
Duje
D
Vukas
D000328:Adult; D003560:Cysts / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000601:surgery; D008107:Liver Diseases / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000209:etiology*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*