Objective: To analyze the etiology, clinical picture, diagnostic methods, surgical treatment and follow up of a series of six patients with large abdominal pseudocyst as a complication of ventriculo-peritoneal shunts for cerebrospinal fluid relief.
Design: Study of a series of cases.
Patients and methods: We studied six patients from 1992 to 1995 with large abdominal pseudocyst; there were four women and two men, with range of age from nine to 19 years, and average of 15.9 years. Diagnosis was supported by clinical findings, ultrasound and computed tomographic scan.
Results: Meningeal tuberculosis was the cause of hydrocephalus, in five cases and neurocysticercosis in one. The most common symptoms were diffuse abdominal pain, nausea and vomiting. All of them presented with abdominal distention and a soft mass filled with liquid that occupied most of the abdominal cavity without evidence of shunt malfunction. All patients underwent surgical treatment for excision of the pseudocyst and relocation of the catheter of the shunt, without morbidity on mortality. In the follow up we have not experienced recurrence of the pseudocyst in any case.
Conclusion: According to our experience, we propose that in a patient with a history of meningeal tuberculosis and ventriculo-peritoneal shunt that presents with an abdominal mass should be investigated for the occurrence of a pseudocyst. The ultrasound and tomographic scan are of great value for diagnosis. Surgical treatment through an open laparotomy is the best option for these patients. Morbidity and mortality are considered low, without evidence of recurrence.