Abdominal wall pseudocyst secondary to lumboperitoneal shunt malpositioning

Case contributed by Dr Ali Alsmair

Presentation

Known to have a lumboperitoneal shunt, now presenting with a newly developed abdominal wall mass on the left side.

Patient Data

Age: 40 years
Gender: Female

Evidence of lumbar peritoneal shunt, with the tip in the subcutaneous tissue of the left anterior abdominal wall. It's not entering the abdominal cavity.
Secondary subcutaneous collection measuring about 4 x 8 x 13 cm is noted and shows extension into the abdominal wall muscles but not beyond it.
Features are consistent with an abdominal wall pseudocyst complicating a malpositioned lumboperitoneal shunt.

There are a few mesenteric lymph nodes with some surrounding fat stranding along the course of superior mesenteric vessels, suggesting mesenteric panniculitis.

Case Discussion

The patient was treated by aspiration of the cyst and repositioning of the tip of the lumboperitoneal shunt. No further imaging was needed.

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