Department of Neurosurgery, CHU Lille, France.
Department of Neurosurgery, CHU Lille, France.
Neurochirurgie. 2021 Apr;67(2):198-200. doi: 10.1016/j.neuchi.2020.09.012. Epub 2020 Nov 6.
Abdominal pseudocysts are common complications of ventriculoperitoneal shunt (VPS). We report the case of a 37-year-old woman treated by VPS for congenital obstructive hydrocephalus, who presented shunt dysfunction related to a voluminous abdominal cyst initially diagnosed as cerebrospinal fluid pseudocyst. The cyst was drained and the VPS was removed after endoscopic third ventriculocisternostomy (ETV). A few months later, a large new abdominal cyst appeared and was operated on. Diagnosis was rectified as massive ovarian mucinous cystadenoma. In any intra-abdominal cyst, differential diagnoses need considering to avoid mis-diagnosis in shunted patients, especially if the cyst is very large. The etiology of the hydrocephalus should also be investigated in case of shunt dysfunction. Even in case of longstanding shunt, ETV can be an alternative to shunt revision surgery in obstructive hydrocephalus, enabling VPS withdrawal and treatment of the hydrocephalus.
腹腔假性囊肿是脑室腹腔分流术（VPS）的常见并发症。我们报告了一例 37 岁女性因先天性梗阻性脑积水接受 VPS 治疗的病例，该患者出现了与巨大腹腔囊肿相关的分流功能障碍，最初诊断为脑脊液假性囊肿。在进行内镜第三脑室造瘘术（ETV）后，囊肿被引流，VPS 被移除。几个月后，一个新的巨大腹部囊肿出现并接受了手术。诊断被修正为巨大卵巢粘液性囊腺瘤。在任何腹腔囊肿中，需要考虑鉴别诊断以避免在分流患者中误诊，特别是如果囊肿非常大。如果出现分流功能障碍，还应调查脑积水的病因。即使在长期分流的情况下，ETV 也可以作为梗阻性脑积水分流修复手术的替代方法，能够移除 VPS 并治疗脑积水。
