Abdominal cerebrospinal fluid pseudocyst: a comparative analysis between children and adults.
OBJECTIVE
Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare but important complication in patients with ventriculoperitoneal shunt (VPS). In addition to presenting our experience, we performed a comparative analysis between children and adults with this entity. To the author's knowledge, there are no studies in which this condition has been compared.


METHODS
The PubMed database was searched for all relevant reports published from 1954 to 2012. The differences were statistically compared, especially regarding clinical investigations, etiology of the hydrocephalus, shunt revision, CSF infection, treatment, and recurrence. Chi-square test or Fisher's exact test was used to find associations among the variables.


RESULTS
Compiled from literature, we found 393 cases of abdominal pseudocyst: 295 children, including our cases, and 55 adults, with age not informed in 43 cases. In children, 33 % of the patients have a positive culture on presentation, with higher incidence in children younger than 10 years. In contrast, only 15 % among adults were positive CSF culture. In total, 287 abdominal pseudocyst cases who underwent shunt revision have been reported; 78.4 % of children and 62.2 % of adults. The main occurrence of this complication according to the etiology of hydrocephalus in children was different from adults. The recurrence of pseudocyst occurred in 19.8 and 24.2 % of children and adults, respectively.


CONCLUSIONS
The differences between children and adults might represent distinct trends on the etiology and treatment of this entity. Hence, additional well-designed cohort studies will be necessary to strengthen our findings.
Division of Neurosurgery, Japanese University Hospital, Av. Japón #50 y 30 Anillo Interno, Santa Cruz de la Sierra, Bolivia, carlosdabdoub@hotmail.com.
Carlos B
CB
Dabdoub
Carlos F
CF
Dabdoub
Mario
M
Chavez
Jimmy
J
Villarroel
Jose L
JL
Ferrufino
Adan
A
Coimbra
Bianca M
BM
Orlandi
D000005:Abdomen / Q000473:pathology*; D000328:Adult; D002555:Cerebrospinal Fluid; D002648:Child; D003560:Cysts / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*