Abdominal cerebrospinal fluid pseudocyst: A complication of ventriculoperitoneal shunt in children

Ben Zion Roitberg*, Tadanori Tomita, David G. McLone

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

The present paper is a retrospective analysis of 27 consecutive patients, treated for abdominal cerebrospinal fluid (CSF) pseudocyst at the Children's Memorial Hospital in the years 1991-1996. This series is compared to the previous experience from our institution. Treatment consisted of the removal of the ventriculoperitoneal (VP) shunt and placement of an external ventricular drain. Antibiotics were administered intravenously for 10 days. The cysts were aspirated intraoperatively in 9 patients and postoperatively with ultrasound guidance in 3 patients, while they resolved spontaneously in 15 others. In 21 of 27 cases (78%), the shunt could be reinserted into the abdomen in a new location. Four patients had a ventriculopleural shunt, and in 2 patients, a ventriculoatrial shunt was inserted. Forty-four percent of the patients had a positive culture on presentation. The positive culture rate was 77% for those 4 years old and younger and only 28% for those aged 5 and above (p = 0.03). We conclude that abdominal CSF pseudocysts are resolved by externalizing the shunt. A VP shunt can be safely reinserted in the majority of the patients. Infection, while an important factor, is not likely to account for all cases of pseudocyst.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalPediatric neurosurgery
Volume29
Issue number5
DOIs
StatePublished - Dec 1 1998

Keywords

  • Cerebrospinal fluid
  • Child
  • Pseudocyst
  • Treatment outcome
  • Ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology

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