TY - JOUR
T1 - Ascites and abdominal pseudocysts following ventriculoperitoneal shunt surgery
T2 - Variations of the same theme
AU - Kariyattil, Rajeev
AU - Steinbok, Paul
AU - Singhal, Ashutosh
AU - Cochrane, D. Douglas
PY - 2007/5
Y1 - 2007/5
N2 - Object. Ascites and abdominal pseudocysts are two complications that can occur following placement of a ventriculoperitoneal (VP) shunt. Although various factors have been implicated, the exact pathogenesis of the two conditions remains elusive. To the authors' knowledge, there are no studies in which these two obviously related conditions have been compared. Methods. The authors retrospectively reviewed the cases of children with abdominal complications caused by a VP shunt. There were 15 patients who developed a pseudocyst and five patients who developed ascites. The cases were analyzed to identify common and distinguishing factors that may help in identifying the mechanism involved. Abdominal symptoms were the mode of presentation for patients with ascites, whereas shunt malfunction was the mode of presentation in 60% of those with pseudocysts. Culture-proven infection, abdominal surgery, and the number of revisions seemed to be more common in cases with pseudocysts than in ascites. The fluid in ascites was found to be a transudate irrespective of the origin of hydrocephalus. Alternative drainage sites were required in the treatment of patients with ascites, and reimplantation in the peritoneum was possible in 66.7% of those with pseudocysts. In the long term, however, peritoneal reimplantation was possible in three of the five patients with ascites. Conclusions. Abdominal pseudocysts and ascites, after VP shunt treatment, are distinct conditions with different modes of presentation and findings during examination of fluid, and therefore they require different management strategies.
AB - Object. Ascites and abdominal pseudocysts are two complications that can occur following placement of a ventriculoperitoneal (VP) shunt. Although various factors have been implicated, the exact pathogenesis of the two conditions remains elusive. To the authors' knowledge, there are no studies in which these two obviously related conditions have been compared. Methods. The authors retrospectively reviewed the cases of children with abdominal complications caused by a VP shunt. There were 15 patients who developed a pseudocyst and five patients who developed ascites. The cases were analyzed to identify common and distinguishing factors that may help in identifying the mechanism involved. Abdominal symptoms were the mode of presentation for patients with ascites, whereas shunt malfunction was the mode of presentation in 60% of those with pseudocysts. Culture-proven infection, abdominal surgery, and the number of revisions seemed to be more common in cases with pseudocysts than in ascites. The fluid in ascites was found to be a transudate irrespective of the origin of hydrocephalus. Alternative drainage sites were required in the treatment of patients with ascites, and reimplantation in the peritoneum was possible in 66.7% of those with pseudocysts. In the long term, however, peritoneal reimplantation was possible in three of the five patients with ascites. Conclusions. Abdominal pseudocysts and ascites, after VP shunt treatment, are distinct conditions with different modes of presentation and findings during examination of fluid, and therefore they require different management strategies.
KW - Abdominal complication
KW - Pediatric neurosurgery
KW - Pseudocyst
KW - Shunt ascites
KW - Ultrasonography
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U2 - 10.3171/ped.2007.106.5.350
DO - 10.3171/ped.2007.106.5.350
M3 - Article
C2 - 17566200
AN - SCOPUS:34250844513
SN - 0022-3085
VL - 106
SP - 350
EP - 353
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
IS - 5 SUPPL.
ER -