Tamura Atsumi, Shida Dai, Tsutsumi Kyosuke
Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Koto-bashi, Sumida-ku, Tokyo 1308575, Japan.
BMC Surg. 2013 Jul 8;13:27. doi: 10.1186/1471-2482-13-27.
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.
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.
Gastroenterological surgeons should be aware of this possible complication, and this complication should be considered during differential diagnosis of an acute abdomen complaint.
脑室腹腔分流术（VPS）是治疗儿童和成人各种病因脑积水的既定手术。腹腔脑脊液假性囊肿是一种罕见的并发症，有潜在生命危险，通常发生在儿童期。然而，随着成功治疗后寿命的延长，它也可能发生在成人身上。
我们在此描述一名22岁男性，因弥漫性腹胀入院。21年前因脊柱裂继发脑积水接受了VPS手术。腹部计算机断层扫描（CT）显示VPS导管尖端附近有均匀的低密度液体积聚，导致胃梗阻。因此怀疑VPS周围有腹膜假性囊肿，并进行了急诊剖腹手术。巨大肿块位于左上腹胃和横结肠系膜之间，正好在网膜囊处。打开囊性肿块，引流清液1500毫升；将VPS远端重新放置在肿块外。因此，诊断为VPS并发症腹腔脑脊液假性囊肿。
胃肠外科医生应意识到这种可能的并发症，在对急性腹痛主诉进行鉴别诊断时应考虑到这种并发症。
