Hepatic Liquoric Cyst as a Complication of Ventriculoperitoneal Shunt Insertion: A Case Report

 

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Abstract

Background The ventriculoperitoneal shunt (VPS) procedure is still the most used technique for management of hydrocephalus. This article reports a case of hepatic cerebrospinal fluid (CSF) pseudocyst as a rare, but important, complication of the VPS insertion.

Case Description An 18-year-old male presented to the hospital complaining of temporal headache and visual turbidity for approximately 3 months with a history of VPS insertion for treatment of hydrocephalus and revision of the valve in adolescence. The diagnosis was based on abdominal imaging, demonstrating an extra-axial hepatic CSF pseudocyst free from infection. Following the diagnosis, the management of the case consisted in the removal and repositioning of the catheter on the opposite site of the peritoneum.

Conclusion The hepatic CSF pseudocyst is an infrequent complication of VPS procedure, but it needs to be considered when performing the first evaluation of the patient. Several techniques are considered efficient for the management of this condition, the choice must be made based on the variables of each individual case.

Resumo

Introdução O procedimento de derivação ventriculoperitoneal (DVP) ainda é a técnica mais utilizada para o tratamento da hidrocefalia. Este artigo relata um caso de pseudocisto de líquido cefalorraquidiano (LCR) hepático como uma complicação rara, mas importante, da inserção do shunt ventriculoperitoneal (VP).

Descrição do Caso Um homem de 18 anos deu entrada no hospital com queixa de cefaleia temporal e turvação visual há aproximadamente 3 meses, com histórico de inserção da DVP para tratamento de hidrocefalia e revisão da válvula na adolescência. O diagnóstico foi baseado em exames de imagem abdominais, demonstrando um pseudocisto hepático extraaxial de LCR, livre de infecção. Após o diagnóstico, o manejo do paciente se baseou na retirada e reposicionamento do cateter no sítio oposto do peritônio.

Conclusão O pseudocisto hepático de LCR é uma complicação infrequente do procedimento de DVP, mas deve ser considerado na primeira avaliação do paciente. Diversas técnicas são consideradas eficientes para o manejo desta condição, a escolha deve ser feita com base nas variáveis de cada caso individual.

Publication History

Received: 14 October 2020

Accepted: 09 March 2021

Article published online:
30 August 2021

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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