Ultrasound-guided percutaneous aspiration of abdominal pseudocyst following ventriculoperitoneal shunt implantation in a child: A case report

Abstract

Pseudocyst is a rare complication of ventriculoperitoneal shunt (VPS) seen in 1–4% of pediatric age group and it’s usually managed by surgical excision. We report a new case of cerebrospinal fluid pseudocyst complicating VPS that was managed by percutaneous aspiration resulting in a successful outcome. A 2-year-old male presented with fever, abdominal pain, diarrhea, and vomiting. Abdomen examination showed palpable tender epigastric mass. Ultrasound examination and CT scan of the abdomen demonstrated localized epigastric fluid collection. He was managed with IV antibiotics, shunt externalization, and percutaneous aspiration of the pseudocyst. On follow-up examination, no similar symptoms were recorded. Percutaneous aspiration is a more conservative and effective approach in managing VPS pseudocyst in the new era of interventional radiology. Although the occurrence of abdominal pseudocyst is rare, a high index of suspicion should be maintained to avoid the risk of ascending infection.

Abdominal pseudocyst complicating ventriculoperitoneal shunt: A rare indication for ventriculopleural shunt conversion

“…It presents with abdominal pain, distention, and a palpable abdominal mass 6–9 . Other symptoms may include fever, decrease in appetite, and diffuse abdominal tenderness 10 . The treatment options for such pseudocysts include surgical removal of the catheter with or without excision of the pseudocyst wall and placement of a new catheter 11 or cyst excision and shunt relocation 12,13 .…”

“…[6][7][8][9] Other symptoms may include fever, decrease in appetite, and diffuse abdominal tenderness. 10 The treatment options for such pseudocysts include surgical removal of the catheter with or without excision of the pseudocyst wall and placement of a new catheter 11 or cyst excision and shunt relocation. 12,13 Shunt relocation includes ventriculoatrial (VA) shunt, ventriculopleural (VPL) shunt, and lumboperitoneal (LP) shunt.…”