Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Puerto Rico
Neurosurgery, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, Puerto Rico.
BMJ Case Rep. 2021 Dec 1;14(12):e246681. doi: 10.1136/bcr-2021-246681.
The formation of an intraperitoneal pseudocyst as a complication of ventriculoperitoneal shunts is well known. However, the formation of a pseudocyst at the subcutaneous extraperitoneal abdominal space is unusual and likely secondary to the migration of the peritoneal catheter. We present a 53-year-old male who had placement of a ventriculoperitoneal shunt for hydrocephalus secondary to a vestibular schwannoma. Five months later, he presented with an enormously distended abdomen. Investigations showed the peritoneal catheter in the extraperitoneal space within a large right lower quadrant abdominal wall pseudocyst. The patient was taken to the operating theatre, and the shunt was externalised at the original abdominal incision. Approximately 3 L of cerebrospinal fluid were aspirated from the distal peritoneal catheter. After negative cultures, a new peritoneal catheter was placed intraperitoneally at the contralateral lower abdominal quadrant. The contralateral quadrant was utilised to prevent fluid accumulation into the old extraperitoneal cavity.
腹腔假性囊肿作为脑室腹腔分流术的并发症已广为人知。然而，腹腔外皮下间隙假性囊肿的形成并不常见，可能是由于腹膜导管迁移所致。我们现介绍一位 53 岁男性，因前庭神经鞘瘤继发脑积水而行脑室腹腔分流术。术后 5 个月，他出现了极度膨胀的腹部。检查显示，腹膜导管位于右下腹部巨大壁假性囊肿的腹膜外间隙内。患者被送往手术室，在原腹部切口处将分流管外置。从远端腹膜导管中吸出约 3 升脑脊液。在培养结果为阴性后，在对侧下腹部象限重新放置了一根新的腹膜导管。使用对侧象限可防止液体积聚在旧的腹膜外腔中。
