Anterior abdominal wall CSF pseudocyst (CSFoma)

  • Approximately 20 ml of slightly cloudy/pale yellow color fluid was aspirated by the neurosurgeon from right upper quadrant abdominal wall collection and sent for laboratory analysis which showed cerebrospinal fluid with many white blood cells (predominantly polymorphonuclear cells & neutrophils) and elevated protein & glucose levels. No organisms were seen on CSF culture. After aspiration, the VP shunt was replaced by the neurosurgeon.
  • Clinical history, imaging features, and laboratory results are suggestive of VP shunt related infected anterior abdominal wall CSF pseudocyst (CSFoma).
  • Ventriculoperitoneal (VP) shunts are frequently used in the treatment of hydrocephalus. These VP shunts are associated with a few complications including fracture, displacement or blockage of the shunt, infection/peritonitis, bowel perforation, volvulus, pseudo-tumor of the mesentery, and cerebrospinal fluid pseudocyst (CSFoma) 1. CSFoma occurs in 1.0-4.5% cases and is presumed to be caused by shunt related infections, high CSF proteins, or peritoneal adhesions 1.