Ventriculoperitoneal shunt with communicating peritoneal & subcutaneous pseudocysts formation

Abstract

A case of cerebrospinal fluid (CSF) pseudocysts in a patient with a ventriculoperitoneal (VP) shunt is reported to describeacute unusual location of developmentof pseudocyst. In the setting of a VP shunt, the frequency of abdominal CSF pseudocyst formation is approximately 4.5%, often being precipitated by a recent inflammatory/infective process or recent surgery. Larger pseudocysts tend to be sterile, whereas smaller or multiloculated pseudocysts are more often infected. Computed tomography (CT) and ultrasound (US) has characteristic findings. This is an uncommon presentation of VP shunt with no evidence of infection. The objective of this case report is to create awareness about imaging findings of complications of VP shunt at an unusual location.

Keywords: Cerebrospinal fluid pseudocyst; Computed tomography; Ultrasound; Ventriculoperitoneal shunt.

Fig. 1-a

Contrast enhanced abdominopelvic CT scan axial images shows 5× 4 x 5 cm well defined non-enhancing cystic area in the right paraumbilical regionalong with internal shunt catheters (arrows).

Fig 1b

Contrast enhanced abdominopelvic CT scan sagittal reformate image showperitoneal and abdominal wall pseudocysts.

Fig. 2

Contrast enhanced abdominopelvic CT scan axial images shows two shunt catheter tubes (arrows).

Fig. 3

Contrast-enhanced abdominopelvic CT scan coronal reformate image shows the course of the catheter surrounded by the pseudocysts formation.