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Post ventriculoperitoneal shunt abdominal pseudocyst: Challenges posed in management
Raashid Hamid1, Aejaz A Baba1, Nisar A Bhat1
1Department of Paediatric and Neonatal Surgery, SKIMS, Srinagar, Jammu and Kashmir, India.
Asian Journal of Neurosurgery
|April 18, 2017
Summary
Abdominal pseudocysts are a rare complication of ventriculoperitoneal (VP) shunts in hydrocephalus patients. Early diagnosis via imaging and surgical intervention are crucial for managing this condition and preventing shunt malfunction.
Area of Science:
- Pediatric Surgery
- Neurosurgery
- Medical Imaging
Background:
- Ventriculoperitoneal (VP) shunts are used to treat hydrocephalus by draining cerebrospinal fluid (CSF) into the abdominal cavity.
- Abdominal complications occur in 5-47% of VP shunt surgeries, with CSF pseudocysts being an uncommon but recognized issue.
Purpose of the Study:
- To investigate the clinical presentation and management strategies for abdominal CSF pseudocysts in children.
- To share institutional experience with this specific VP shunt complication.
Main Methods:
- Retrospective analysis of 4 pediatric cases with abdominal pseudocysts post-VP shunt insertion (2008-2013).
- Clinical suspicion was confirmed using abdominal ultrasonography.
Main Results:
- Three patients presented with multilocular cysts; one had a unilocular cyst at the distal shunt end.
- All patients exhibited signs of increased intracranial pressure; two also had abdominal symptoms.
- Open exploration was required for all cases, involving cyst drainage, partial/complete excision, and shunt repositioning or exteriorization.
Conclusions:
- Abdominal pseudocysts are a rare but significant complication of VP shunts, potentially causing shunt malfunction and abdominal issues.
- Prompt diagnosis through imaging and surgical management, including shunt repositioning, are recommended for suspected cases.