Document Detail

An alternative approach for management of abdominal cerebrospinal fluid pseudocysts in children.
MedLine Citation:
PMID:  16944175     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cerebrospinal fluid (CSF) abdominal pseudocyst is an uncommon but important complication of ventriculoperitoneal shunts. From the collected series, several features about the etiology and management become apparent. Retrospective data were obtained from 12 children treated with cerebrospinal fluid abdominal pseudocyst defined an alternative approach for management of these patients. METHODS: There were eight girls and four boys who ranged in age from 12 days to 18 years old (mean 7.7 months). The most frequent etiology of the hydrocephalus was Chiari type II malformation in six cases. Initial presentation with shunt malfunction was detected in nine cases. Abdominal distention and/or pain were the most frequent finding in our series (10/12). In only one case, infection was detected for all cerebrospinal fluid abdominal pseudocysts (8.3%). Ventriculoperitoneal shunt (VPS) externalization, antibiotics, and cyst aspiration was performed in 8/12 cases as initial management of abdominal pseudocyst. Ventriculoperitoneal shunt reinsertion in abdominal cavity and/or endoscopic third ventriculostomy (ETV) was performed as final management in 9/12. Ventriculoatrial shunt was used only in three cases. Recurrence of the abdominal cyst was observed in two cases. DISCUSSION: Based on the success rate (75%) in our series submitted to this management, a ventriculoperitoneal shunt can be safely reinserted in the majority of the patients. Endoscopic third ventriculostomy could be performed in selected cases as an alternative approach. Although infection has been reported as responsible for pseudocyst formation, it was only exceptionally found in our series.
Ricardo Santos de Oliveira; Aline Barbosa; Yvone Avalloni de Moraes Villela de Andrade Vicente; Hélio Rubens Machado
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Publication Detail:
Type:  Journal Article     Date:  2006-08-30
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  23     ISSN:  0256-7040     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2006-12-04     Completed Date:  2007-11-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  85-90     Citation Subset:  IM    
Division of Pediatric Neurosurgery, Ribeirão Preto School of Medicine, University of São Paulo, Campus Universitário, São Paulo, 14049-900, Brazil.
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MeSH Terms
Abdomen / pathology*
Cerebrospinal Fluid*
Child, Preschool
Cysts / etiology*,  therapy*
Hydrocephalus / surgery
Infant, Newborn
Retrospective Studies
Third Ventricle
Ventriculoperitoneal Shunt / adverse effects*

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