Cerebrospinal fluid ascites complicating a ventriculoperitoneal shunt

Area of Science:

• Neurosurgery
• Pediatric Neurology
• Gastroenterology

Background:

• Hydrocephalus is often treated with cerebrospinal fluid shunts.
• Ventriculoperitoneal shunts are common for cerebrospinal fluid diversion.
• Recurrent craniopharyngioma can cause third ventricle obstruction and hydrocephalus.

Observation:

• A patient presented with intermittent cerebrospinal fluid ascites.
• The ascites complicated a ventriculoperitoneal shunt.
• Ascites resolved spontaneously and with paracentesis.

Findings:

• The exact cause of cerebrospinal fluid ascites was unclear.
• The peritoneal cavity appeared to "reject" cerebrospinal fluid.
• Ascites resolved without requiring ventriculoatrial shunt conversion.

Implications:

• This case highlights an unusual complication of ventriculoperitoneal shunts.
• Understanding cerebrospinal fluid ascites mechanisms is important for shunt management.
• Conservative management may resolve ascites, avoiding more invasive procedures.