Peritoneal Pseudocyst - Ventriculo-Peritoneal Shunt Complications

Abstract

Pseudocyst formation is a rare complication of ventriculo-peritoneal shunt, occurring in only 22 cases of 1300 shunts from 1968 to 1992. The most common presentation is that of abdominal signs rather than neurological or infectious signs. The diagnosis is easy with ultrasonography. The difficulty is to evocate the cyst and to correlate symptoms and cyst. Treatment of the cyst was by aspiration (21 cases) and excision in 7 cases. The therapeutic choice is made according to the ultrasound findings. When the cyst was infected, an external ventricular shunt was used temporary, but this type of shunt must be avoided where possible. Three patients died.

Abdominal Cerebrospinal Fluid Pseudocyst: A Complication of Ventriculoperitoneal Shunt in Children

“…Abdominal pseudocysts are a well-known complication of VP shunting of CSF, with incidence ranging from less than 1% [1,3] to 4.5% [6]. Their diagnosis requires a high index of suspicion because in many cases, all the symptoms are abdominal, especially in older patients, with no signs of increased intracranial pressure or infection [1][2][3][4][5].…”

“…Surgical exploration of the abdomen was frequently mentioned in the earlier series, either as a diagnostic procedure or to remove the cyst wall [3,7]. Laparotomy is still reported for this condition even in some recent studies [1,6,8]. Others maintain that catheter removal with external ventricular drainage (EVD) and sometimes cyst drainage is adequate [2,4].…”

“…Occasionally, signs of acute infection predominate, such as acute abdomen [2,4]. Less than 1% of all shunted patients develop a pseudocyst [1,3,4,5], although higher rates were reported as well [6].…”

“…Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon complication of ventriculoperitoneal (VP) shunting [1][2][3][4]. It may lead to symptoms related to either shunt obstruction, abdominal mass or both.…”

Preventive Stitching for Migration of a Peritoneal Catheter Into the Abdominal Wall After Ventriculoperitoneal Shunting -Technical Note-

“…Migration of the peritoneal catheter into the abdominal wall, that is the epi-peritoneal layer, is a complication of the distal end of the catheter which results in malfunction of the shunt with pooling of cerebrospinal fluid in the abdominal wall. Repositioning of the migrated catheter is possible, 1,2,[4][5][6]9) but corrective measures have not been detailed. We have developed a preventive abdominal stitching method for this complication.…”