A bdominal Cerebrospinal Fluid Pseudocyst: A Rare Complication of Ventriculoperitoneal Shunt and a Case Report

腹腔腦脊髓液偽囊腫：一則少見的腦室腹膜腔引流管併發症之病例報告

楊智全(Chih-Chuan Yang) ； 張宏昌(Hung-Chang Chang) ； 蔡耀中(Yao-Chung Tsai)

《Formosan Journal of Surgery》 37卷2期 (2004/04) Pp. 86-90

摘要

腦室腹腔引流手術是治療水腦症患者最常使用的手術方式，而腦室腹腔引流手術相關的各種併發症也經常被報導。本篇報導一個腦室腹腔引流術後產生腹腔內偽囊腫併發症的罕見病例。這個患者在早產出生後，即因水腦症接受腦室腹腔引流手術。病患九歲的時候，發現有持續嘔吐及活動力降低的情形，同時在右側腹壁有一個突出腫塊。經腹部超音波及電腦斷層檢查後，診斷為腹腔內囊腫。經剖腹探查及囊腫切除手術後，患者症狀改善並出院。已接受腦室腹腔引流手術之病患，若懷疑有併發腹腔內偽囊腫致腹部相關症狀時，腹部超音波或電腦斷層檢查可以提供一個早期的鑑別診斷。治療上，一般以偽囊腫的處理及引流管的置換手術，可以達到預期的療效。這個病例報告中，病患因為腸粘黏及狹窄而接受部分小腸切除手術，在沒有感染的前提下，同時施予囊腫的切除及引流管位置的變更，也達到同樣的療效。

並列摘要

Ventriculoperitoneal shunts are commonly employed in the management of hydrocephalus but numerous and various complications have been reported in the medical literature. We reported a case of an abdominal cerebrospinal fluid pseudocyst as a rare complication of ventriculoperitoneal shunt. The patient, prematurely born, underwent a ventriculoperitoneal shunt at birth because of hydrocephalus. At the age of 9 he suffered from frequent vomiting, and poor activity was found and persisted for one month. In the meanwhile, a bulging mass was noted over the right lower abdominal wall. On abdominal ultrasonography and computed topography scan, the patient was diagnosed as having an abdominal cyst. Laparotomy with removal of the cyst and segmental intestinal resection due to adhesion and stenosis led to the uneventful recovery of the patient. It is suggested that in a patient where there is suspicion of an abdominal pseudocyst that developed abdominal symptoms and signs following a ventriculoperitoneal shunt, ultrasonography and/or abdominal CT provide a definitive diagnosis of this entity. Meanwhile, simple cyst evacuation and shunt reposition might be the sufficient treatment for this complication, if infection is not present.

並列關鍵字

ventriculoperitoneal shunt ； abdominal pseudocyst ； complication