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Abdominal cerebrospinal fluid pseudocysts
Insights
Abdominal pseudocysts are an uncommon complication of ventriculoperitoneal shunts. Consider this diagnosis in VP-shunted patients with abdominal symptoms.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Gastroenterology
Background:
- Ventriculoperitoneal (VP) shunts are common for hydrocephalus.
- Abdominal cerebrospinal fluid pseudocysts are a rare but significant complication.
- Early diagnosis and management are crucial to prevent morbidity.
Purpose of the Study:
- To review cases of abdominal cerebrospinal fluid pseudocysts in patients with VP shunts.
- To identify clinical features, diagnostic methods, and outcomes.
- To emphasize the importance of considering this diagnosis in affected patients.
Main Methods:
- Retrospective review of ten patients diagnosed with abdominal pseudocysts.
- Analysis of patient demographics, shunt history, clinical presentation, diagnostic imaging, and treatment.
- Correlation of shunt infection and surgical intervention with recurrence rates.
Main Results:
- Ten patients (5 male, 5 female) aged 4 months to 14 years were identified.
- Symptoms were primarily abdominal; three patients showed shunt malfunction.
- Ultrasound diagnosed all pseudocysts; shunt infection was present in six patients.
- Repositioning the peritoneal catheter was associated with higher recurrence rates.
Conclusions:
- Abdominal pseudocysts should be considered in VP-shunted patients presenting with abdominal complaints.
- Prompt diagnosis via ultrasound is effective.
- Management strategies should aim to minimize recurrence, especially in cases of shunt infection.
Abstract:
Abdominal cerebrospinal fluid pseudocyst in an infrequent complication of ventriculoperitoneal (VP) shunts. We reviewed ten patients with abdominal pseudocyst. There were five girls and five boys, aged between 4 months and 14 years. The number of shunt procedures prior to the presentation varied between one and five. Only one patient had had a previous shunt infection. No patients had undergone prior abdominal surgery other than VP shunting. The time from the last shunting procedure to the development of abdominal pseudocyst ranged from 3 weeks to 5 years. Presenting symptoms and signs were mainly related to abdominal complaints in all patients. Three patients also had signs of shunt malfunction. The diagnosis was made by ultrasound in all patients. Shunt infection was determined in six patients. Repositioning if the peritoneal catheter seemed to have a higher rate of recurrence. The diagnosis of abdominal pseudocyst should be considered in VP-shunted patients presenting with abdominal complaints.