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Lassoed liver: hepatic pseudo-fissure caused by ventriculoperitoneal shunt
Ronald S Chan1, Andrew Poznanski
1676 North St. Clair, Suite 800, Chicago, IL 60611, USA. chanr01@hotmail.com
Insights
A ventriculoperitoneal shunt infection in a child led to a unique liver deformity. This unusual finding, resembling a pseudo-fissure, can complicate abdominal imaging interpretation.
Area of Science:
- Pediatric Surgery
- Medical Imaging
- Gastrointestinal Radiology
Background:
- Ventriculoperitoneal shunts are common in treating hydrocephalus.
- Shunt infections can necessitate catheter removal.
- Intraperitoneal placement of shunt catheters carries potential complications.
Observation:
- A 2-year-old child with a shunt infection and prior revision presented with a peculiar liver invagination.
- This deformity was noted on CT scan along the path of the removed intraperitoneal catheter.
- The invagination was presumed to be a direct result of the catheter's presence.
Findings:
- A novel case of liver deformity secondary to an intraperitoneal shunt catheter.
- The observed pseudo-fissure mimicked pathological conditions on imaging.
- This specific complication has not been previously documented in medical literature.
Implications:
- Radiologists and surgeons should be aware of this potential shunt complication.
- The liver deformity may lead to misinterpretation of abdominal imaging (CT/Ultrasound).
- Further investigation may be needed to differentiate this artifact from true pathology.
Abstract:
A 2-year-old child with a ventriculoperitoneal shunt and a shunt revision 18 months previously developed a shunt infection. A CT scan of the abdomen was performed soon after the shunt catheter was removed. A peculiar invagination in the liver was demonstrated along the same course of a recently removed intraperitoneal catheter, presumably caused by the catheter. There have been no reported cases of deformity and pseudo-fissure of the liver, which may mimic pathologic processes on ultrasound or CT, caused by a ventriculoperitoneal shunt.