TY - JOUR T1 - Sterile cerebrospinal fluid ascites, hydrothorax and hydrocele as a complication of ventriculoperitoneal shunting in an elderly patient JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2021-242593 VL - 14 IS - 7 SP - e242593 AU - Xiancheng Wu AU - Michael Sandhu AU - Rajat Dhand AU - Leen Alkukhun AU - Jivan Lamichhane Y1 - 2021/07/01 UR - http://casereports.bmj.com/content/14/7/e242593.abstract N2 - An 89-year-old man with a history of multiple abdominal surgeries and ventriculoperitoneal (VP) shunt placement for normal pressure hydrocephalus presented for intractable abdominal bloating and scrotal swelling, for which imaging revealed massive ascites, bilateral hydrocele and small bilateral pleural effusions. Cardiac, hepatic and renal workup were insignificant. Culture and cytology of ascitic fluid were negative for infection or malignancy. Aetiology of the ascites as secondary to Cerebrospinal fluid (CSF) from the VP shunt was confirmed via ligation of the shunt. Sterile CSF ascites, hydrothorax and hydrocele are rare complications of VP shunt for hydrocephalus and are mostly presented in paediatric patients. We report the first known case of concurrent CSF ascites, hydrothorax and hydrocele in an elderly patient. We examine the difficulty of shunt replacement as a diagnostic and treatment modality in this age group and propose the use of reversible shunt ligation as a diagnostic modality. ER -