Cerebrospinal fluid liver pseudocyst:A bizarre long-term complication of ventriculoperitoneal shunt:A case report  

作　　者：Muhammad Nadeem Yousaf Haider A Naqvi Shriya Kane Fizah S Chaudhary Jason Hawksworth Vikram V Nayar Thomas W Faust 

机构地区：[1]Division of Gastroenterology and Hepatology,Department of Medicine,University of Missouri,Columbia,MO 65212,United States [2]Department of Medicine,MedStar Union Memorial Hospital,Baltimore,MD 21218,United States [3]Department of Surgery,University Iowa School of Medicine,Iowa City,IA 52242,United States [4]Department of Medicine,University of Missouri,Columbia,MO 65212,United States [5]Department of Surgery,Transplant Hepatology,MedStar Georgetown University Hospital,Washington,DC 20007,United States [6]Department of Neurosurgery,MedStar Georgetown University Hospital,Washington,DC 20007,United States [7]Department of Medicine,Transplant Hepatology,James D.Eason Transplant Institute,Methodist Le Bonheur Healthcare,Memphis,TN 38104,United States

出　　处：《World Journal of Hepatology》2023年第5期715-724,共10页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Ventriculoperitoneal(VP)shunt placement has become a standard of care procedure in managing hydrocephalus for drainage and absorption of cerebrospinal fluid(CSF)into the peritoneum.Abdominal pseudocysts containing CSF are the common long-term complication of this frequently performed procedure,mainly because VP shunts have significantly prolonged survival.Of these,liver CSF pseudocysts are rare entities that may cause shunt dysfunction,affect normal organ function,and therefore pose therapeutic challenges.CASE SUMMARY A 49-year-old man with history of congenital hydrocephalus status post bilateral VP shunt placement presented with progressively worsening dyspnea on exertion,abdominal discomfort/distention.Abdominal computed tomography(CT)scan revealed a large CSF pseudocyst in the right hepatic lobe with the tip of VP shunt catheter into the hepatic cyst cavity.Patient underwent robotic laparoscopic cyst fenestration with a partial hepatectomy,and repositioning of VP shunt catheter to the right lower quadrant of the abdomen.Follow-up CT demonstrated a significant reduction in hepatic CSF pseudocyst.CONCLUSION A high index of clinical suspicion is required for early detection of liver CSF pseudocysts since their presentation is often asymptomatic and cunning early in the course.Late-stage liver CSF pseudocysts could have adverse outcomes on the treatment course of hydrocephalus as well as on hepatobiliary dysfunction.There is paucity of data to define the management of liver CSF pseudocyst in current guidelines due to rare nature of this entity.The reported occurrences have been managed by laparotomy with debridement,paracentesis,radiological imaging guided fluid aspiration and laparoscopic-associated cyst fenestration.Robotic surgery is an additional minimally invasive option in the management of hepatic CSF pseudocyst;however,its use is limited by lack of widespread availability and cost of surgery.

关 键 词：SHUNT fluid PERITONEAL 

分 类 号：R651.1[医药卫生—外科学]