Peritoneal CSF pseudocysts

Case contributed by Dr Paul Simkin

Presentation

Ventriculoperitoneal shunt inserted after surgery for brain tumour. Routine follow up.

Patient Data

Age: 33
Gender: Male
CT

CT abdomen/pelvis

CT of the upper abdomen shows a large water density collection in the right upper quadrant, engulfing the ventriculoperitoneal shunt tubing. The collection exerts mass effect on the adjacent liver. A smaller collection is seen surrounding the shunt in the gallbladder fossa.

The collection had been stable over serial follow-up CT scans spanning 3 years. While biochemical assay of the collection has not been performed at our institution to confirm CSF, the proximity to the shunt makes this most likely.

Case Discussion

This pseudocyst has been described as peritoneal, but it is possible that the VP shunt has penetrated the hepatic capsule, and the large collection may in fact be subcapsular.

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Case information

rID: 24023
Case created: 24th Jul 2013
Last edited: 11th Oct 2015
Inclusion in quiz mode: Included

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