Department of Neurosurgery, University Hospital of Rijeka, Rijeka, Croatia.
Wien Klin Wochenschr. 2010 Nov;122(21-22):641-4. doi: 10.1007/s00508-010-1474-2. Epub 2010 Oct 22.
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.
我们有一位 30 岁女性患者,患有继发性脑积水。她在前交通动脉瘤破裂并成功夹闭后,接受了脑室-腹腔分流术(VPS)植入。VPS 植入后 3 周,出现发热、呼吸和腹部困难。我们通过超声(US)和计算机断层扫描(CT)诊断为脑脊液性肝假性囊肿。由于我们在脑脊液中发现了细菌,我们将 VPS 转换为外部脑室引流(EVD)。之后,我们进行了超声引导下的 CSF 肝假性囊肿穿刺和引流。随后的腹部 CT 显示囊肿形态有所消退。在诊断为脑脊液性肝假性囊肿一个月后,患者死于感染性休克合并多器官功能衰竭(MOF)。VPS 远端穿透腹膜器官是一种罕见的并发症,很可能是分流感染和免疫反应的结果,这种反应发生在定位感染的过程中。