title: Symptomatic vaginal enterocele associated with malfunctioning ventriculoperitoneal shunt and cerebrospinal ascites.
abstract: Abdominal pseudocyst formation is a rare adult complication associated with ventriculoperitoneal (VP) shunts. Presenting symptoms are primarily abdominal and include distention, pain and anorexia, and secondarily neurological with signs and symptoms of shunt malfunction. We describe a case of VP shunt-related pseudocyst formation presenting as symptomatic pelvic organ prolapse with stage 4 enterocele 4 years after VP shunt placement. The patient's vaginal enterocele enlarged and became more symptomatic as intra-abdominal cyst formation expanded. Symptomatic relief of pelvic floor symptomatology including resolution of exteriorized prolapse was established by conservative measures and eventual VP shunt revision and removal. VP shunt malfunction may present as symptomatic pelvic organ prolapse and may require shunt removal or revision for resolution of symptoms.
authors.affiliation: Section of Urogynecology/Reconstructive Pelvic Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA. karpd@ccf.org
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Karp
authors.forename: Tazeen Z
authors.initials: TZ
authors.lastname: Rizvi
authors.forename: G Willy
authors.initials: GW
authors.lastname: Davila
mesh_terms: D000328:Adult; D001201:Ascites / Q000150:complications*; D020878:Device Removal; D005260:Female; D006801:Humans; D020047:Rectocele / Q000209:etiology*; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*