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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
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Deflating abdominal pseudocyst causing temporary normalization of ventriculoperitoneal shunt malfunction
Mubarak Ali Algahtany1, Zeljko Kojadinovic2, Aws Algahtany3
1Mubarak Ali Algahtany, Division of Neurosurgery, Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia.
Pakistan Journal of Medical Sciences
|August 22, 2022
Summary
A rare abdominal pseudocyst (APC) can cause variable ventriculoperitoneal shunt (VPS) function. This pseudocyst may collapse during ultrasound, leading to missed diagnosis and temporary improvement.
Area of Science:
- Neurosurgery
- Radiology
- Gastroenterology
Background:
- Ventriculoperitoneal shunts (VPS) are crucial for hydrocephalus management.
- Abdominal pseudocysts (APC) are rare VPS complications causing shunt malfunction.
- Variable VPS function due to APC has not been previously documented.
Observation:
- A patient with hydrocephalus and bilateral VPS experienced right-sided shunt malfunction.
- Initial abdominal ultrasound was unremarkable, followed by temporary clinical improvement and relapse.
- Subsequent CT scan revealed an APC near the peritoneal catheter tip.
Findings:
- The APC was successfully treated with laparoscopic intervention, resolving the shunt malfunction.
- It is hypothesized that the APC collapsed during abdominal ultrasound, leading to its missed detection.
- This collapse explains the transient improvement and subsequent relapse observed in the patient.
Implications:
- Introduces the concept of APC-related variable VPS function.
- Suggests ultrasound compression may cause pseudocyst collapse, complicating diagnosis.
- Highlights contrasted CT as superior to ultrasound for APC detection and recommends targeted ultrasound examination.
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