Ventricule-shunt abdominal complications

Resumo

The ventriculoperitoneal shunt (VPS) is a solution to relieving symptoms of excess cerebral-ventricle cerebrospinal fluid (CSF); draining this extra fluid to the peritoneum. Other forms of shunts exist though less used in relation to VPS; whose choice is mainly determined by patient’s clinical presentation and regressive history. Though rare, VPS is not devoid of complications. Furthermore, primary abdominal complications are rarer, though most present as peritonitis, abscess or shunt catheter dissociation, each with varying short and long term consequences. Recently, abdominal fluid collections are drawing increasing interest, particularly in relation to: encysted collections (abdominal pseudocysts-APC) and excess cerebrospinal fluid (CSF) accumulation (called CSF ascites). We present a case of an abdominal APC diagnosed in an outpatient treated at our referral centre, and explore the involved clinical and surgical aspects. This patient was successfully treated and evolved well post-operatively and up-to-date. Despite vast evolution in neurosurgery, VPS continues being the prima choice in treating hydrocephalus, a procedure prone to complications just like any surgery, though rare. Non-draining shunts usually warrant revision which usually means at least a reoperation. Mechanisms leading to APC formation remain unknown, although a previous bout of sub-clinical peritonitis continues being the dominant hypothesis.