Hepatic subcapsular CSF pseudocyst

Discussion:

This is an unusual complication of VP shunt placement. The abdominal end of the tube dissects the hepatic capsule and enter the hepatic parenchyma. As the tube has many holes for CSF drainage most of CSF drained through the extra hepatic holes while small amount collects within the liver resulted in slowly growing pseudocyst. Due to patient's history of trauma, it was initially interpreted as subcapsular hematoma however the average density of the fluid was lower than hemorrhage (2 HU). Surgical revision of the shunt tube was done.

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