Wang Bh, Hasadsri L, Wang H
University of Illinois, Urbana, USA.
J Surg Case Rep. 2012 Jul 1;2012(7):6. doi: 10.1093/jscr/2012.7.6.
Abdominal cerebrospinal fluid pseudocysts (APC) are a relatively uncommon complication of ventriculoperitoneal (VP) shunts, and most frequently occur in the pediatric population. Pediatric patients most often present with neurological sequelae, however, adults may present with abdominal complaints. Here we report a case of a nineteen year-old female with a VP shunt who presented with only abdominal distension suggestive of a full-term pregnancy. Abdominal CT studies subsequently established a diagnosis of APC. A total of 12.7L of fluid was drained laparoscopically, and the VP shunt was eventually revised into a ventriculo-atrial shunt. Because adult patients often present years after their VP shunt procedures with only abdominal complaints, the diagnosis of APC relies on detailed history taking and a strong clinical suspicion. The aetiology, presentation, diagnosis and treatment of APC are also reviewed.
腹腔脑脊液假性囊肿(APC)是脑室腹腔(VP)分流术相对少见的并发症,最常发生于儿童人群。儿科患者最常表现为神经后遗症,然而,成人可能表现为腹部不适。在此,我们报告一例19岁女性VP分流术后患者,仅表现为腹部膨隆,提示足月妊娠。随后腹部CT检查确诊为APC。通过腹腔镜引流了总计12.7升液体,最终将VP分流术改为脑室心房分流术。由于成年患者常在VP分流术后数年才出现仅腹部不适的症状,APC的诊断依赖于详细的病史采集和高度的临床怀疑。本文还对APC的病因、表现、诊断和治疗进行了综述。