Management strategies for giant abdominal pseudocyst in a patient with ventriculoperitoneal shunt

Authors

  • Prateek Madaan Government Medical College and Hospital, Chandigarh, India
  • Inayat Grewal Government Medical College and Hospital, Chandigarh, India
  • Vipin K. Gupta Department of Neurosurgery, Government Medical College and Hospital, Chandigarh, India
  • Anshul Kulshreshtha Department of Neurosurgery, Government Medical College and Hospital, Chandigarh, India
  • Soumya Gupta Government Medical College and Hospital, Chandigarh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20211331

Keywords:

Hydrocephalus, Abdominal pseudocyst, Tubercular meningitis, Ventriculopleural shunt

Abstract

Ventriculoperitoneal (VP) shunt is considered as the mainstay treatment of hydrocephalus, it remains as one of the most failure prone surgical interventions worldwide. Abdominal pseudocyst (APC) is one of the rare complications of VP shunt and is more prevalent in paediatric population. In this case, the patient is an 11-year-old male with history of tubercular meningitis with hydrocephalus for which VP shunt was done and the patient developed a giant abdominal pseudocyst which is the 3rd largest pseudocyst reported till date in a paediatric patient known best to our knowledge. This case is particularly unique due to rapid development of such a large pseudocyst in a span as short as 6 weeks. In this article, the causes of formation of APC and the treatment protocol to manage the patient with abdominal pseudocyst secondary to VP shunt are also discussed.

References

Rajshekhar V. Management of hydrocephalus in patients with tuberculous meningitis. Neurol India. 2009;57(4):368-74.

Ohba S, Kinoshita Y, Tsutsui M, Nakagawa T, Shimizu K, Murakami H, et al. Formation of abdominal cerebrospinal fluid pseudocyst: case report. Neurol Med Chir. 2012;52(11):838-42.

Well GTJV, Paes BF, Terwee CB, Springer P, Roord JJ, Donald PR, et al. Twenty years of pediatric tuberculous meningitis: a petrospective cohort study in the Western Cape of South Africa. Pediatrics. 2009;123(1):1-8.

Bhargava S, Gupta AK, Tandon PN. Tuberculous meningitis: a CT study. Br J Radiol. 1982;55(651):189–96.

Ozateş M, Kemaloglu S, Gürkan F, Ozkan U, Hoşoglu S, Simşek MM. CT of the brain in tuberculous meningitis: a review of 289 patients. Acta Radiol. 2000;41(1):13-7.

Schoeman J, Donald P, Zyl LV, Keet M, Wait J. Tuberculous hydrocephalus: comparison of different treatments with regard to ICP, ventricular size and clinical outcome. Dev Med Child Neurol. 1991;33(5):396-405.

Dabdoub CB, Dabdoub CF, Chavez M, Villarroel J, Ferrufino JL, Coimbra A, et al. Abdominal cerebrospinal fluid pseudocyst: a comparative analysis between children and adults. Childs Nerv Syst. 2014;30(4):579-589.

Dabdoub CB, Fontoura EA, Santos EA, Romero PC, Diniz CA. Hepatic cerebrospinal fluid pseudocyst: a rare complication of ventriculoperitoneal shunt. Surg Neurol Int. 2013;4:162.

Yuh S, Vassilyadi M. Management of abdominal pseudocyst in shunt-dependent hydrocephalus. Surg Neurol Int. 2012;3:146.

Harsh GR. Peritoneal shunt for hydrocephalus, utilizing the fimbria of the fallopian tube for entrance to the peritoneal cavity. J Neurosurg. 1954;11(3):284-94.

Wang BH, Hasadsri L, Wang H. Abdominal cerebrospinal fluid pseudocyst mimicking full-term pregnancy. Journal of Surgical Case Reports. 2012;2012(7):6.

Lee C, Cheng W, Shen C. Large pseudocyst in the anterior extraperitoneal space as a complication of ventriculoperitoneal shunt. Formo J Surg. 2015;48(4):130-2.

Lukhi H, Singh M, Chakravarthy S, Perwez N. Largest Abdominal CSF Pseudocyst–An Uncommon Complication of VP Shunt. NJR. 2013;3(1):89-90.

Ayan E, Tanriverdi HI, Caliskan T, Senel U, Karaarslan N. Intraabdominal pseudocyst developed after ventriculoperitoneal shunt: a case report. J Clin Diagn Res. 2015;9(6):5-6.

Ouladsaiad M, Hokoumi H, Aballa N. A giant abdominal cerebrospinal fluid pseudocyst. Iran J Neurosurg. 2017;3(3):109-14.

Yim SB, Chung YG, Won YS. Delayed abdominal pseudocyst after ventriculoperitoneal shunt surgery: a case report. Nerve. 2018;4(2):111-4.

Pathi R, Sage M, Slavotinek J, Hanieh A. Abdominal cerebrospinal fluid pseudocyst. Australas Radiol. 2004;48(1):61-3.

Rainov N, Schobess A, Heidecke V, Burkert W. Abdominal CSF pseudocysts in patients with ventriculo-peritoneal shunts. Report of fourteen cases and review of the literature. Acta Neurochir. 1994;127(1-2):73-8.

Aparici-Robles F, Molina-Fabrega R. Abdominal cerebrospinal fluid pseudocyst: a complication of ventriculoperitoneal shunts in adults. J Med Imaging Radiat Oncol. 2008;52(1):40-3.

Anderson CM, Sorrells DL, Kerby JD. Intraabdominal pseudocysts as a complication of ventriculoperitoneal shunts. J Am Coll Surg. 2003;196(2):297–300.

Rovlias A, Kotsou S. Giant abdominal CSF pseudocyst in an adult patient 10 years after a ventriculo-peritoneal shunt. Br J Neurosurg. 2001;15(2):191-2.

Sharma AK, Pandey AK, Diyora BD, Mamidanna R, Sayal PP, Ingale HA. Abdominal CSF pseudocyst in a pateint with ventriculoperitoneal shunt. Indian Journal of Surgery. 2004;66(6):360-3.

Anwar R, Sadek A, Vajramani G. Abdominal pseudocyst: a rare complication of ventriculoperitoneal shunting. 2017;17(3):212-3.

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Published

2021-03-26

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Section

Case Reports