Abdominal cerebrospinal fluid pseudocyst mimicking full-term pregnancy

Abdominal cerebrospinal fluid pseudocysts (APC) are a relatively uncommon complication of ventriculoperitoneal (VP) shunts, and most frequently occur in the pediatric population. Pediatric patients most often present with neurological sequelae, however, adults may present with abdominal complaints. Here we report a case of a nineteen year-old female with a VP shunt who presented with only abdominal distension suggestive of a full-term pregnancy. Abdominal CT studies subsequently established a diagnosis of APC. A total of 12.7L of fluid was drained laparoscopically, and the VP shunt was eventually revised into a ventriculo-atrial shunt. Because adult patients often present years after their VP shunt procedures with only abdominal complaints, the diagnosis of APC relies on detailed history taking and a strong clinical suspicion. The aetiology, presentation, diagnosis and treatment of APC are also reviewed.