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Related Experiment Videos

Peritoneal pseudocyst--ventriculo-peritoneal shunt complications

R Besson1, J P Hladky, P Dhellemmes

  • 1Service de Chirurgie Pédiatrique, Hôpital Huriez, CHRU Lille, France.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|August 1, 1995
PubMed
Summary

Pseudocyst formation is a rare complication of ventriculo-peritoneal (VP) shunts, often presenting with abdominal signs. Diagnosis is straightforward with ultrasonography, guiding treatment choices like aspiration or excision.

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Area of Science:

  • Neurosurgery
  • Pediatric Surgery
  • Medical Imaging

Background:

  • Ventriculo-peritoneal (VP) shunts are common for hydrocephalus.
  • Pseudocyst formation is a rare but significant complication of VP shunts.
  • Abdominal signs are the most frequent presentation, overshadowing neurological or infectious symptoms.

Purpose of the Study:

  • To review the incidence, presentation, diagnosis, and management of pseudocysts complicating VP shunts.
  • To highlight the diagnostic utility of ultrasonography in identifying these cysts.
  • To analyze treatment outcomes and identify factors influencing therapeutic decisions.

Main Methods:

  • Retrospective review of 22 cases of pseudocyst formation among 1300 VP shunts (1968-1992).
  • Analysis of clinical presentations, diagnostic methods (primarily ultrasonography), and treatment strategies.

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  • Correlation of ultrasound findings with therapeutic choices and patient outcomes.

    • Main Results:

    • Pseudocysts occurred in 22 of 1300 VP shunts.
    • Abdominal signs were the predominant presentation.
    • Ultrasonography facilitated diagnosis; treatment involved aspiration (21 cases) or excision (7 cases).
    • Infected cysts necessitated temporary external ventricular shunts, though these are generally discouraged.

    Conclusions:

    • Pseudocyst formation is an uncommon but recognized complication of VP shunts.
    • Ultrasonography is crucial for diagnosis, and treatment selection depends on cyst characteristics.
    • Prompt diagnosis and appropriate management are essential, with a mortality rate of approximately 13.6% (3/22 patients).