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Abdominal cerebrospinal fluid pseudocyst occurring 21 years after ventriculoperitoneal shunt placement: a case report

机译:腹膜-脑-腹腔分流放置21年后发生的腹部脑脊液假性囊肿:1例报告

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Background Ventriculoperitoneal shunt (VPS) placement is an established procedure for the treatment of hydrocephalus of diverse etiologies in children and adults. Abdominal cerebrospinal fluid pseudocyst, which is potentially life threatening, is a rare complication and usually occurs during childhood. However, with increasing longevity following successful treatment, it can also occur in adults. Case presentation Here we describe a 22-year-old man who was admitted to our hospital because of diffuse abdominal distention. A VPS was placed 21 years earlier to treat hydrocephalus secondary to spina bifida. Abdominal computed tomography (CT) revealed a homogeneous low-density fluid collection adjacent to the VPS catheter tip, causing stomach obstruction. Thus a peritoneal pseudocyst around VPS was suspected and emergency laparotomy was performed. The large mass was localized in the left upper abdomen between the stomach and mesentery of the transverse colon, exactly at the omental bursa. The cystic mass was opened and 1500 ml of clear fluid was drained; the distal end of the VPS was repositioned outside the mass. Thus, an abdominal cerebrospinal fluid pseudocyst as a complication of VPS was diagnosed. Conclusion Gastroenterological surgeons should be aware of this possible complication, and this complication should be considered during differential diagnosis of an acute abdomen complaint.
机译:背景腹膜腹腔分流术(VPS)放置是治疗儿童和成人各种病因脑积水的既定程序。可能会危及生命的腹部脑脊液假性囊肿是一种罕见的并发症,通常发生在儿童时期。然而,随着成功治疗后寿命的延长,它也可能在成人中发生。病例介绍在这里,我们描述了一名22岁的男子,他因腹部弥漫性膨胀而入院。在21年前放置了VPS,以治疗继发于脊柱裂的脑积水。腹部计算机断层扫描(CT)显示邻近VPS导管尖端的均一的低密度液体收集物,导致胃阻塞。因此怀疑有VPS周围的腹膜假性囊肿,并进行了紧急剖腹手术。大量肿块位于胃和横结肠肠系膜之间的左上腹部,恰好在网膜囊处。打开囊性肿块,排出1500 ml澄清液体。 VPS的远端重新定位在肿块外部。因此,诊断为VPS并发症的腹部脑脊液假性囊肿。结论肠胃外科医师应意识到这种可能的并发症,并应在鉴别诊断急性腹部主诉时考虑该并发症。

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