Yang Tae Ki, Sim Ki-Bum
Department of Neurosurgery, Jeju National University Hospital, Jeju University School of Medicine, Jeju, Korea.
J Korean Neurosurg Soc. 2013 Nov;54(5):441-3. doi: 10.3340/jkns.2013.54.5.441. Epub 2013 Nov 30.
Liver abscess following ventriculoperitoneal (VP) shunting occurs very rarely. We report an unusual case of multiple liver abscesses caused by Staphylococcus capitis in a 50-year-old compromised woman due to a complicating VP shunt infection. We reviewed the nine cases of VP shunt complications reported in the English literature, and speculated that the most likely pathogenetic mechanism in our case is an infected peritoneal tip that migrated to and penetrated the liver, which subsequently caused the formation of multiple liver abscesses. The patient was successfully treated with percutaneous aspiration, drainage of the abscesses, intravenous antibiotics, and shunt revision. Awareness and vigilance of the possibility of liver abscess formation caused by VP shunt infection will help establish an early accurate diagnosis and therapeutic strategy.
脑室腹腔（VP）分流术后发生肝脓肿极为罕见。我们报告了一例不寻常的病例，一名50岁的免疫功能低下女性因VP分流感染并发多例由头状葡萄球菌引起的肝脓肿。我们回顾了英文文献中报道的9例VP分流并发症病例，并推测我们病例中最可能的发病机制是感染的腹腔端迁移并穿透肝脏，随后导致多个肝脓肿形成。该患者通过经皮穿刺抽吸、脓肿引流、静脉使用抗生素及分流修复成功治愈。认识并警惕VP分流感染导致肝脓肿形成的可能性将有助于早期准确诊断并制定治疗策略。
