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Huge subcutaneous extraperitoneal pseudocyst after migration of the ventriculoperitoneal shunt catheter
  1. Orlando De Jesus,
  2. Christian Rios-Vicil,
  3. Joel E Pellot Cestero and
  4. Eric F Carro-Figueroa
  1. Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Puerto Rico
  1. Correspondence to Orlando De Jesus; drodejesus{at}


The formation of an intraperitoneal pseudocyst as a complication of ventriculoperitoneal shunts is well known. However, the formation of a pseudocyst at the subcutaneous extraperitoneal abdominal space is unusual and likely secondary to the migration of the peritoneal catheter. We present a 53-year-old male who had placement of a ventriculoperitoneal shunt for hydrocephalus secondary to a vestibular schwannoma. Five months later, he presented with an enormously distended abdomen. Investigations showed the peritoneal catheter in the extraperitoneal space within a large right lower quadrant abdominal wall pseudocyst. The patient was taken to the operating theatre, and the shunt was externalised at the original abdominal incision. Approximately 3 L of cerebrospinal fluid were aspirated from the distal peritoneal catheter. After negative cultures, a new peritoneal catheter was placed intraperitoneally at the contralateral lower abdominal quadrant. The contralateral quadrant was utilised to prevent fluid accumulation into the old extraperitoneal cavity.

  • hydrocephalus
  • gastrointestinal surgery
  • neurosurgery
  • radiology

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  • Contributors Creation of study: ODJ, CR-V, JEPC and ECF-F. Article drafting: ODJ, CR-V, JEPC and ECF-F. Approving final version: ODJ, CR-V, JEPC and ECF-F.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.