scholarly journals An Intra-Abdominal Pseudocyst around a Ventriculoperitoneal Shunt due toStreptococcusInfection 7 Years after Shunt Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Arata Tomiyama ◽  
Jun-ichi Harashina ◽  
Hitoshi Kimura ◽  
Keisuke Ito ◽  
Yoshihiko Honda ◽  
...  
Keyword(s):  
Obstructive Hydrocephalus ◽  
Abdominal Mass ◽  
Abdominal Cavity ◽  
Chronic Phase ◽  
Abdominal Distension ◽  
Shunt Surgery ◽  
Postoperative Course ◽  
Vp Shunt ◽  
Shunt Tube ◽  
Abdominal Pseudocyst

In 1999, a 50-year-old woman underwent ventriculoperitoneal (VP) shunt surgery for hydrocephalus after subarachnoid hemorrhage. She was hospitalized for fever and recurrent systemic seizures in November 2006. Head computed tomography (CT) showed only old changes. The seizures and fever were controlled by medicinal therapy. However, in December, her consciousness level suddenly decreased, and she showed progressive lower abdominal distension. Head CT showed marked ventriculomegaly, and abdominal CT showed a giant cystic mass at the shunt-tube tip in the lower abdominal cavity. Because thick pus was aspirated from the intra-abdominal mass, we diagnosed the patient with acute obstructive hydrocephalus due to an infected abdominal pseudocyst. Laparotomy and direct cyst drainage were performed, and antibiotic therapy againstStreptococcus,the causative pathogen, was administered. The VP shunt tube was replaced. The postoperative course was uneventful, and postoperative CT showed hydrocephalus improvement and no pseudocyst recurrence. Abdominal pseudocysts, which are rare after VP shunt surgeries, usually occur after the subacute postoperative course in younger cerebral hemorrhagic cases. Our case was quite rare because the cyst developed in the chronic phase in an older patient and was caused by streptococcal infection. The cyst components should be examined before cyst drainage when choosing surgical strategies.

scholarly journals Abdominal Cerebrospinal Fluid Pseudocyst Diagnosed with Point-of-care Ultrasound

2019 ◽  
Vol 3 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Brittany Guest ◽  
Michael Merjanian ◽  
Emily Chiu ◽  
Caleb Canders
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Point Of Care ◽  
Secondary Infection ◽  
Abdominal Cavity ◽  
Abdominal Distension ◽  
Point Of Care Ultrasound ◽  
Vp Shunt ◽  
Abdominal Complications ◽  
Abdominal Pseudocyst

Abdominal pseudocysts are rare complications of ventriculoperitoneal (VP) shunts characterized by accumulations of cerebrospinal fluid surrounded by fibrous layers in the intra-abdominal cavity or abdominal wall. We present a woman with bilateral VP shunts who presented with right-sided abdominal distension, pain, and tenderness and who was found to have an abdominal pseudocyst on point-of-care ultrasound and computed tomography. Given the potential to develop a secondary infection or VP shunt malfunction, it is important for emergency providers to consider intra-abdominal complications of VP shunts, including rare ones such as abdominal pseudocysts, in these patients who present with vague abdominal complaints.

scholarly journals Cerebrospinal Fluid Pseudocyst Complicating Ventriculoperitoneal Shunt: Report of Four Cases

2018 ◽  
Vol 07 (02) ◽  
pp. 135-138 ◽  
Author(s):  
Pradyumna Pan
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Presentation ◽  
Abdominal Distension ◽  
Surgical Removal ◽  
Ultrasound Guided ◽  
Vp Shunt ◽  
Multilocular Cyst ◽  
Computed Tomographic ◽  
Abdominal Pseudocyst ◽  
Uncommon Complication

Abstract Background Cerebrospinal fluid (CSF) abdominal pseudocyst (APC) is an uncommon complication following ventriculoperitoneal (VP) shunt. Aim To study the clinical features and management of this entity. The authors present their experience with cases of CSF pseudocyst in children. Materials and Methods Retrospective analysis of four cases diagnosed to have APC following VP shunt between 2005 and 2015. Results Clinical presentation was with progressive abdominal distension, highlights of intestinal obstruction, and signs of raised intracranial pressure (ICP). Diagnosis is readily made with ultrasonography and computed tomographic (CT) scan of the abdomen. The duration between insertion of the shunt and the presentation ranged from 4.11 to 12 years. In three patients, the cyst was unilocular and of varying size. The fourth one had a multilocular cyst. In three patients, the treatment involved was surgical removal of the catheter with excision of the pseudocyst wall and placement of a new catheter intraperitoneally in a different quadrant. Ultrasound-guided aspiration of the cyst and relocation of the distal end was done in one patient. Conclusion Initial suspicion with appropriate investigation and early treatment can avert morbidity and mortality.

scholarly journals Pseudocyst of Abdomen Presenting as a Huge Abdominal Mass after Ventriculoperitoneal Shunt: A Case Report

2021 ◽  
Vol 10 (2) ◽  
pp. 87-89
Author(s):  
Suman Adhikari ◽  
Prabin Bhandari ◽  
Balgopal Karmacharya ◽  
Nikunja Yogi
Keyword(s):  
Case Report ◽  
Ventriculoperitoneal Shunt ◽  
Rare Complication ◽  
Abdominal Mass ◽  
Epithelial Lining ◽  
Vp Shunt ◽  
Abdominal Pseudocyst ◽  
Surgical Modality ◽  
Shunt Obstruction ◽  
Pseudocyst Formation

A ventriculoperitoneal shunt is a major surgical modality to relieve intracranial pressure in patients with hydrocephalus. Shunt obstruction and infection are the most common complications following shunt surgery whereas VP shunt-associated pseudocyst formation is a rare complication. These are the cystic space without the epithelial lining, filled with fluid around the distal tip of the catheter. In this case report, we present you a 47-year-old male who underwent VP shunt placed a year back presented with huge abdominal swelling, headache, and weight loss. CT scan of the abdomen showed abdominal pseudocyst with the peritoneal end of the shunt within the cyst. Though the exact mechanism is not known, abdominal adhesion, multiple revisions, obstruction, or dislodgement are thought to predispose to the formation of a pseudocyst.

scholarly journals A Prospective Study and Analysis of Ventriculoperitoneal Shunt Surgery: Their Indication and Complication in a Single Tertiary Care Center

2021 ◽  
Author(s):  
Barnava Pal ◽  
Sambuddha Dhar ◽  
Anurag Sahu ◽  
Sumita Kumari ◽  
Kulwant Singh ◽  
...  
Keyword(s):  
Obstructive Hydrocephalus ◽  
Care Center ◽  
Tertiary Care ◽  
Normal Pressure ◽  
Shunt Surgery ◽  
Shunt Insertion ◽  
Vp Shunt ◽  
Male Predominance ◽  
Shunt Complications ◽  
Csf Analysis

Abstract Background Ventriculoperitoneal (VP) shunt insertion is routinely performed for the treatment of hydrocephalus due to different indications like congenital, infective, tumor, posttraumatic, and normal pressure hydrocephalus (NPH). A lot of common and rare complications following this procedure have been reported. Objectives To analyze the clinical profile, indications, anesthetic, and postoperative complications for VP shunt surgery in our center. Materials and Methods This prospective clinical review study was conducted in the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, between October 2018 to January 2020 and included 454 cases of hydrocephalus who underwent VP shunt surgery. The data was compiled and analyzed. Results A total of 454 patients with male predominance were studied. Pediatric and adolescent patients were 48.9% (222/454). Obstructive hydrocephalus due to tumors was the etiology of 48.7% (221/454) cases. The incidence of overall shunt complications was 9.7% (44/454), of which obstruction and infection was 5.9% (27/454) and 3.1% (14/454), respectively. Factors associated with increased shunt complications include redo and infective etiology and cases having higher protein in perioperative cerebrospinal fluid (CSF) analysis. Neuronavigation, antibiotic-impregnated shunt and biventricular shunt are associated with lower complications. Conclusion Obstructive hydrocephalus due to tumors happened to be the most common cause of VP shunt, and shunt obstruction is most common complication, especially in infective and redo cases.

The case of prenatal diagnosis of a germ cell tumor of the fetal ovary

2018 ◽  
Author(s):  
N.N. Bondarenko, E.Yu. Andreeva , N.B. Filippova
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Ovarian Tumor ◽  
Ultrasound Examination ◽  
Abdominal Mass ◽  
Abdominal Cavity ◽  
Cell Tumor ◽  
Fetal Ovary ◽  
Entire Abdominal Cavity ◽  
Spontaneous Delivery

A case of prenatal ultrasound diagnosis of a rare congenital ovarian tumor is presented. By ultrasound examination at 36–37 weeks of gestation the intra-abdominal mass 66  47  74 mm occupying the entire abdominal cavity was discovered. At 38 weeks of pregnancy spontaneous delivery occurred with girl weight 2840 g. On the eighth day after birth the child has been successfully undergone surgery. Histological examination revealed congenital germ-cell tumor with structures of dysgerminoma and yolk sac tumor.

scholarly journals Unilateral mydriasis in a child with a ventriculoperitoneal shunt for obstructive hydrocephalus: a diagnostic dilemma

2020 ◽  
Vol 13 (12) ◽  
pp. e237257
Author(s):  
Monidipa Banerjee ◽  
Eiman Haj Ahmed ◽  
Kathryn Foster ◽  
Arundoss Gangadharan
Keyword(s):  
Ipratropium Bromide ◽  
Obstructive Hydrocephalus ◽  
Sudden Onset ◽  
Unique Case ◽  
Diagnostic Dilemma ◽  
Vp Shunt ◽  
Life Threatening ◽  
Unilateral Mydriasis ◽  
The Brain ◽  
Rule Out

There are several causes for sudden onset unilateral mydriasis, however impending transtentorial uncal herniation needs to be ruled out. This unique case highlights an uncommon adverse response to a common mode of treatment that leads to a diagnostic dilemma. A 3-year-old boy with a ventriculoperitoneal (VP) shunt for an obstructive hydrocephalus presented with an acute respiratory distress. He developed unilateral mydriasis with absent light reflex during treatment with nebulisers. An urgent CT scan of the brain did not show any new intracranial abnormality. A case of pharmacological anisocoria was diagnosed that resolved completely within 24 hours of discontinuation of ipratropium bromide. Although ipratropium-induced anisocoria has been reported in children, but to our knowledge none in a child with VP shunt for hydrocephalus. This emphasises the urgency in evaluating unilateral mydriasis to rule out life-threatening conditions. Clinicians should remember that ipratropium administered through ill-fitting face masks could cause this completely reversible adverse effect.

scholarly journals Hemorrhagic abdominal pseudocyst following ventriculoperitoneal shunt: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hong-Cai Wang ◽  
Yi-Lei Tong ◽  
Shi-Wei Li ◽  
Mao-Song Chen ◽  
Bo-Ding Wang ◽  
...  
Keyword(s):  
Fibrous Tissue ◽  
Clinical Signs ◽  
Chronic Subdural Hematoma ◽  
Normal Pressure ◽  
Cystic Mass ◽  
Shunt Revision ◽  
Subdural Effusion ◽  
Palpable Mass ◽  
Vp Shunt ◽  
Abdominal Pseudocyst

Abstract Background Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but important complication of ventriculoperitoneal (VP) shunts. While individual articles have reported many cases of abdominal CSF pseudocyst following VP shunts, no case of a hemorrhagic abdominal pseudocyst after VP shunts has been reported so far. Case presentation This article reports a 68-year-old woman with a 4-month history of progressive abdominal pain and distention. She denied any additional symptoms. A VP shunt was performed 15 years earlier to treat idiopathic normal pressure hydrocephalus and no other abdominal surgery was performed. Physical examination revealed an elastic palpable mass in her right lower abdomen, which was dull to percussion. Abdominal computed tomography (CT) scan indicated a large cystic collection of homogenous iso-density fluid in the right lower abdominal region with clear margins. The distal segment of the peritoneal shunt catheter was located within the cystic mass. Abdominal CSF pseudocyst was highly suspected as a diagnosis. Laparoscopic cyst drainage with removal of the whole cystic mass was performed, 15-cm cyst which found with thick walls and organized chronic hematic content. No responsible vessel for the cyst hemorrhage was identified. No further shunt revision was placed. Histological examination showed that the cyst wall consisted of outer fibrous tissue and inner granulation tissue without epithelial lining, and the cystic content was chronic hematoma. The patient had an uneventful postoperative course and remained asymptomatic for 8-mo follow-up. Conclusion To the best of our knowledge, this is the first report of hemorrhagic onset in the abdominal pseudocyst following VP shunt. Such special condition can accelerate the appearance of clinical signs of the abdominal pseudocyst after VP shunts, and its mechanisms may be similar to the evolution of subdural effusion into chronic subdural hematoma (CSDH).

scholarly journals Giant adrenal hemangioma: Unusual cause of huge abdominal mass

2015 ◽  
Vol 9 (11-12) ◽  
pp. 834 ◽  
Author(s):  
Mohamed Tarchouli ◽  
Adil Boudhas ◽  
Moulay Brahim Ratbi ◽  
Mohamed Essarghini ◽  
Noureddine Njoumi ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Abdominal Mass ◽  
Abdominal Distension ◽  
Microcytic Anemia ◽  
Hypochromic Microcytic Anemia ◽  
Normal Limits ◽  
Laboratory Examinations ◽  
Right Lobe ◽  
The Right

Adrenal hemangioma is an extremely rare benign and non-functioning neoplasm of the adrenal gland. We report a case of a 71-year-old woman admitted for intermittent abdominal pain and abdominal distension associated with vomiting and chronic constipation for 5 years. Physical examination revealed a large abdominal mass. Both computed tomography scan and magnetic resonance imaging suggested hemangioma in the right lobe of the liver. Laboratory examinations and tumour markers were within normal limits, except for hypochromic microcytic anemia. The mass was removed intact by conventional surgery and histopathology revealed a cavernous hemangioma of the adrenal gland with no signs of malignancy. Surgical resection was curative, with no recurrence at the 2-year follow-up.

scholarly journals Brain Studded with Innumerable Larger Stones: Starry Sky at Night Appearance: Multiple Calcified Giant Tuberculoma with 15 Years of Follow-up

2017 ◽  
Vol 06 (02) ◽  
pp. 155-158
Author(s):  
Guru Satyarthee ◽  
P. Chandra ◽  
A. Mahapatra
Keyword(s):  
Central Nervous System Involvement ◽  
Definitive Diagnosis ◽  
Shunt Surgery ◽  
Unique Case ◽  
Major Health Problem ◽  
Major Health ◽  
Vp Shunt ◽  
Cranial Ct ◽  
Rising Incidence

AbstractTuberculosis is rapidly reemerging as a major health problem due to rising incidence of HIV cases across the globe. Central nervous system involvement is rare, but rarely multiple intracerebral granulomas can occur or occasional solitary tuberculoma also develops. The authors report a unique case of 24-year-old woman suffering from pulmonary tuberculosis developed headache and vomiting. Cranial CT scan revealed multiple widespread deposit of intracranial granuloma of sizeable lesion mimicking starry sky at night appearance. Excision of one tuberculoma was done for confirmation of definitive diagnosis, and histopathology was suggestive of tuberculoma. The patient also underwent VP shunt surgery. At last follow-up at 15 years following surgery, she was doing well.

Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo

1991 ◽  
Vol 70 (6) ◽  
pp. 2611-2618 ◽  
Author(s):  
T. Mutoh ◽  
W. J. Lamm ◽  
L. J. Embree ◽  
J. Hildebrandt ◽  
R. K. Albert
Keyword(s):  
Chest Wall ◽  
Respiratory System ◽  
Functional Residual Capacity ◽  
Total Lung Capacity ◽  
Abdominal Cavity ◽  
Abdominal Distension ◽  
Abdominal Pressure ◽  
Lung Capacity ◽  
Lung Expansion ◽  
Residual Capacity

Abdominal distension (AD) occurs in pregnancy and is also commonly seen in patients with ascites from various causes. Because the abdomen forms part of the "chest wall," the purpose of this study was to clarify the effects of AD on ventilatory mechanics. Airway pressure, four (vertical) regional pleural pressures, and abdominal pressure were measured in five anesthetized, paralyzed, and ventilated upright pigs. The effects of AD on the lung and chest wall were studied by inflating a liquid-filled balloon placed in the abdominal cavity. Respiratory system, chest wall, and lung pressure-volume (PV) relationships were measured on deflation from total lung capacity to residual volume, as well as in the tidal breathing range, before and 15 min after abdominal pressure was raised. Increasing abdominal pressure from 3 to 15 cmH2O decreased total lung capacity and functional residual capacity by approximately 40% and shifted the respiratory system and chest wall PV curves downward and to the right. Much smaller downward shifts in lung deflation curves were seen, with no change in the transdiaphragmatic PV relationship. All regional pleural pressures increased (became less negative) and, in the dependent region, approached 0 cmH2O at functional residual capacity. Tidal compliances of the respiratory system, chest wall, and lung were decreased 43, 42, and 48%, respectively. AD markedly alters respiratory system mechanics primarily by "stiffening" the diaphragm/abdomen part of the chest wall and secondarily by restricting lung expansion, thus shifting the lung PV curve as seen after chest strapping. The less negative pleural pressures in the dependent lung regions suggest that nonuniformities of ventilation could also be accentuated and gas exchange impaired by AD.

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