Skip to main content
SpringerLink
Log in

CSF liver pseudocyst as a complication of a ventriculoperitoneal shunt

Mit cerebro-spinaler Flüssigkeit gefüllte Pseudozyste der Leber als Komplikation eines Ventrikel-Peritoneal Shunts

  • Case report
  • Published:
Wiener klinische Wochenschrift Aims and scope Submit manuscript

Zusammenfassung

Wir berichten über eine 30-jährige Patientin, die an einem sekundären Hydrocephalus litt. Nach Ruptur und erfolgreicher Klippung eines Aneurysmas der Arteria communicans anterior war ihr ein Ventrikel-peritonealer Shunt (VPS) gesetzt worden. 3 Wochen später traten respiratorische und abdominelle Probleme, sowie Fieber auf. Durch Ultraschall und Computertomographie diagnostizierten wir eine mit cerebrospinaler Flüssigkeit (CSF) gefüllte Pseudozyste in der Leber. Nachdem wir in der CSF Bakterien feststellten, wandelten wir den VPS in einen externen Ventrikeldrain um. Danach wurde eine Ultraschall gezielte Punktion und Drainage der CSF-Leber Pseudozyste durchgeführt. Die Kontroll-CT des Abdomens zeigte eine Regression der zystischen Formation. Die Patientin verstarb 1 Monat nach der Diagnose der CSF – gefüllten Leber Pseudozyste im Sepsisbedingten Multiorganversagen. Die Perforation parenchymatöser abdomineller Organe durch das distale Ende des VPS stellt eine seltene Komplikation dar. Sie ist wahrscheinlich Folge einer Infektion des Shunts und einer immunologischen Reaktion, die während der Lokalisierung der Infektion stattfand.

Summary

We have a 30-year-old female patient suffering from secondary hydrocephalus. She has had a ventriculoperitoneal shunt (VPS) implanted following a rupture and a successful clipping of the aneurysm of the anterior communicating artery (ACoA). Three weeks after implanting of the VPS, respiratory and abdominal difficulties with febrility appeared. We diagnosed cerebrospinal fluid liver pseudocyst using ultrasound (US) and computer tomography scan (CT). Given that we found bacteria in the cerebrospinal fluid (CSF), we converted VPS into an external ventricular drain (EVD). After that, we conducted a US-guided punction and drainage of the CSF liver pseudocyst. The subsequent CT of abdomen showed a regression of the cystic form. The patient died following the septic condition with multiple organ failures (MOF) a month after the cerebrospinal fluid liver pseudocyst diagnosis.The perforation of parenhimatose abdominal organs with distal part of VPS is a rare complication which is most likely a consequence of a shunt infection and of an immunological reaction that took place during the process of localizing an infection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Alonso-Vanegas M, Alvarez JL, Delgado L, Mendizabal R, Jimenez JL. Gastric perforation due to VPS. Pediatr Neurosurg 1994;21:192–4

    Article  CAS  PubMed  Google Scholar 

  • Black PMcL. Hydrocephalus and vasospasam following subarachnoid haemorrhag from ruptured intracranial aneurysms. Neurosurgery 1986;18:12–6

    Article  CAS  PubMed  Google Scholar 

  • Chuang VP, Fried AM, Oliff M, Ellis GT, Sachatello CR. Abdominal CSF pseudocyst secondary to ventriculoperitoneal shunt: diagnosis by computed tomography in two cases. J Comput Assist Tomogr 1978;2:88–91

    Article  CAS  PubMed  Google Scholar 

  • Dean DF, Keller IB. Cerebrospinal fluid ascites: a complication of ventriculoperitoneal shunt. J Neurol Neurosurg Psychiatry 1972;35:474

    Article  CAS  PubMed  Google Scholar 

  • Doh JW, Bae HG, Lee KS, Yun IG, Byon BJ. Hydrothorax from intrathoracic migration of a ventriculoperitoneal shunt cathether. Surg Neurol 1995;43:340–3

    Article  CAS  PubMed  Google Scholar 

  • Echizenya K, Satoh M, Mural H. Mineralization and biodegradation of CSF shunting systems. J Neurosurg 1987;67:584

    Article  CAS  PubMed  Google Scholar 

  • Fisher RA, Rodziewicz G, Selman WR, White RJ, Vibhakar SD. Liver abscess: complication of ventriculoperitoneal shunt. Neurosurgery 1984;14:480–2

    Article  CAS  PubMed  Google Scholar 

  • Frazier JL, Wang PP, Patel SH, Benson JE, Cameron DE, Hoon AH Jr, Avellino AM. Unusual migration of the distal catheter of a ventriculoperitoneal shunt into the heart. Neurosurgery 2002;51:819–22

    Article  PubMed  Google Scholar 

  • Gower DJ, Lewis JC, Kelly DL. Steril shunt malfunction: a scanning electron microscop perspective. J Neurosurg 1984;62:1079

    Google Scholar 

  • Ghritlaharey RK, Budhwani KS, Shrivastava DK, Gupta G, Kushwaha AS, Chanchlani R, Nanda M. Trans-anal protrusion of ventriculo-peritoneal shunt catheter with silent bowel perforation: report of ten cases in childern. Pediatr Surg Int 2007;23:575–80

    Article  PubMed  Google Scholar 

  • Gupta A, Ahmad FA, Kumar A, Gaikwad S, Vaishya S. Umbilical CSF fistula: a rare complication of ventriculoperitoneal shunt. Acta Neurochir 2006;148:1205–7

    Article  CAS  Google Scholar 

  • Haralampopoulos F, Iliadis H, Karniadakis S, Koutentakis D. Invasion of a peritoneal catheter into the inferior vena cava: report of a unique case. Surg Neurol 1996;46:21–2

    Article  CAS  PubMed  Google Scholar 

  • Huang LT, Chen CE, Shih TY, Ko SF, Lvi CC. Pyogenic liver abscess complicating a VPS. Pediatr Surg Int 1998;13(1):6–7

    Article  CAS  PubMed  Google Scholar 

  • Kim HB, Raghavendran K, Kleinhaus S. Menagament of an abdominal cerebrospinal fluid pseudocyst using laparoscopic techniques. Surg Laparosc Endosc 1995;5(2):151–4

    CAS  PubMed  Google Scholar 

  • Laucks SS II, Ballantine TVN, Boal DK. Abscess of the falciform ligament in a child with a ventriculoperitoneal shunt. J Pediatr Surg 1986;13:247–53

    Google Scholar 

  • Leyon JJ, Kaliaperumal C, Flynn PA, Gray JW, Kelly MG, Choudhari KA. Broncho-pleural fistual due to trans-diaphragmatic migration of the distal end of ventriculo-peritoneal shunt. Clin Neurol Neurosurg 2008;110:276–8

    Article  PubMed  Google Scholar 

  • Mata J, Alegret X, Llauger J. Splenic pseudocyst as a complication of ventriculoperitoneal Shunt: CT features. J Comput Assist Tomogr 1986;10(2):341–2

    Article  CAS  PubMed  Google Scholar 

  • Park CK, Wang KC, Seo JK, Cho BK. Transoral protrusion of a peritoneal catheter: a case report and literature review. Child's Nerv Syst 2000;16:184–9

    Article  CAS  Google Scholar 

  • Patel CD, Matloub H. Vaginal perforation as a complication of ventriculoperitoneal shunt. J Neurosurg 1973;39:775–6

    Article  Google Scholar 

  • Sakoda TH, Maxwell JA, Brackett CE. Intestinal volvulus secondary to a ventriculoperitoneal shunt. J Neurosurg 1971;35:95–6

    Article  CAS  PubMed  Google Scholar 

  • Sathyanarayana S, Wylen EL, Baskaya MK, Nanda A. Spontaneous bowel perforation after ventriculoperitoneal shunt surgery: case report and a review of 45 cases. Surg Neurol 2000;54:388–96

    Article  CAS  PubMed  Google Scholar 

  • Shetty PG, Fatterpekar GM, Sahani DV, Shroff MM. Pneumocephalus secondary to colonic perforation by ventriculoperitoneal shunt catheter. Br J Radiol 1999;72:704–5

    CAS  PubMed  Google Scholar 

  • Viets DH, Stier FM, Bergman SM. Urinary tract obstruction secondary to cerebrospinal fluid cysts. Urology 1979;13(5):541–3

    Article  CAS  PubMed  Google Scholar 

  • Vinchon M, Baroncini M, Laurent T, Patrick D. Bowel perforation caused by peritoneal shunt catheters: diagnosis and treatment. Neurosurgery 2006;58[ONS Suppl 1]:76–82

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Rijeka, Rijeka, Croatia

    Zlatko Kolić & Duje Vukas

  2. Department of Radiology, University Hospital of Rijeka, Rijeka, Croatia

    Melita Kukuljan

  3. Department of Neurology, University Hospital of Rijeka, Rijeka, Croatia

    David Bonifačić

Authors
  1. Zlatko Kolić
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Melita Kukuljan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Bonifačić
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Duje Vukas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Bonifačić.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kolić, Z., Kukuljan, M., Bonifačić, D. et al. CSF liver pseudocyst as a complication of a ventriculoperitoneal shunt. Wien Klin Wochenschr 122, 641–644 (2010). https://doi.org/10.1007/s00508-010-1474-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-010-1474-2

Keywords

Search

Navigation