Dabdoub Carlos B, Dabdoub Carlos F, Chavez Mario, Villarroel Jimmy, Ferrufino Jose L, Coimbra Adan, Orlandi Bianca M
Division of Neurosurgery, Japanese University Hospital, Av. Japón #50 y 30 Anillo Interno, Santa Cruz de la Sierra, Bolivia,
Childs Nerv Syst. 2014 Apr;30(4):579-89. doi: 10.1007/s00381-014-2370-2. Epub 2014 Jan 29.
Abdominal cerebrospinal fluid (CSF) pseudocyst is a rare but important complication in patients with ventriculoperitoneal shunt (VPS). In addition to presenting our experience, we performed a comparative analysis between children and adults with this entity. To the author's knowledge, there are no studies in which this condition has been compared.
The PubMed database was searched for all relevant reports published from 1954 to 2012. The differences were statistically compared, especially regarding clinical investigations, etiology of the hydrocephalus, shunt revision, CSF infection, treatment, and recurrence. Chi-square test or Fisher's exact test was used to find associations among the variables.
Compiled from literature, we found 393 cases of abdominal pseudocyst: 295 children, including our cases, and 55 adults, with age not informed in 43 cases. In children, 33 % of the patients have a positive culture on presentation, with higher incidence in children younger than 10 years. In contrast, only 15 % among adults were positive CSF culture. In total, 287 abdominal pseudocyst cases who underwent shunt revision have been reported; 78.4 % of children and 62.2 % of adults. The main occurrence of this complication according to the etiology of hydrocephalus in children was different from adults. The recurrence of pseudocyst occurred in 19.8 and 24.2 % of children and adults, respectively.
The differences between children and adults might represent distinct trends on the etiology and treatment of this entity. Hence, additional well-designed cohort studies will be necessary to strengthen our findings.
腹腔脑脊液（CSF）假性囊肿是脑室腹腔分流术（VPS）患者中一种罕见但重要的并发症。除了介绍我们的经验外，我们还对患有这种疾病的儿童和成人进行了比较分析。据作者所知，尚无对这种情况进行比较的研究。
在PubMed数据库中检索1954年至2012年发表的所有相关报告。对差异进行统计学比较，特别是在临床检查、脑积水病因、分流器翻修、脑脊液感染、治疗和复发方面。使用卡方检验或Fisher精确检验来发现变量之间的关联。
根据文献汇编，我们发现393例腹腔假性囊肿病例：295例儿童，包括我们的病例，55例成人，43例未提及年龄。儿童中，33%的患者在就诊时培养结果呈阳性，10岁以下儿童的发病率更高。相比之下，成人中脑脊液培养阳性的仅占15%。总共报告了287例接受分流器翻修的腹腔假性囊肿病例；儿童为78.4%，成人62.2%。根据脑积水病因，儿童和成人这种并发症的主要发生情况不同。假性囊肿的复发率在儿童和成人中分别为19.8%和24.2%。
儿童和成人之间的差异可能代表了这种疾病在病因和治疗方面的不同趋势。因此，需要更多精心设计的队列研究来强化我们的发现。
