+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst



Critical ventriculo-peritoneal shunt failure due to peritoneal tuberculosis: Case report and diagnostic suggestions for abdominal pseudocyst



Surgical Neurology International 5: 71



Tuberculous peritonitis (TBP) is a well-known complication of ventriculo-peritoneal (VP) shunt treatment for hydrocephalus resulting from tuberculous meningitis (TBM). However, a case of hydrocephalus unrelated to TBM resulting from VP shunt malfunction due to TBP has not been reported. A 21-year-old male presented with nausea, abdominal pain, and headache. VP and cysto-peritoneal (CP) shunts had been inserted to treat hydrocephalus due to a suprasellar arachnoid cyst, replaced the VP and removed the CP in his childhood. Computed tomography demonstrated acute hydrocephalus and an abdominal pseudocyst surrounding the distal end of the peritoneal tube. Initial laboratory data showed elevated white blood cell count and C-reactive protein level, but no causative pathogen was identified. External drainage of cerebrospinal fluid (CSF) and of the fluid in the peritoneal cyst was established, and empirical antibiotic therapy was initiated. Bacterial cultures eventually revealed Mycobacterium tuberculosis infection, and TBP was diagnosed. The patient responded well to antituberculosis (anti-TB) agents and insertion of a ventriculo-pleural shunt. This case highlights the possibility of CSF shunt failure and concomitant neurological sequelae from TB infection even when the pathogen has not invaded the central nervous system, as in TBM. Moreover, TBP is rare in developed countries and therefore may be misdiagnosed because of nonspecific clinical features and low sensitivity of common TB screening methods.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052387544

Download citation: RISBibTeXText

PMID: 24991474

DOI: 10.4103/2152-7806.132583


Related references

Laparoscopic-assisted placement of ventriculo-peritoneal shunt tips in children with multiple previous open abdominal ventriculo-peritoneal shunt surgeries. European Journal of Pediatric Surgery 19(2): 79-82, 2009

Giant abdominal CSF pseudocyst in an adult patient 10 years after a ventriculo-peritoneal shunt. British Journal of Neurosurgery 15(2): 191-192, 2001

The sonographic signs of the peritoneal pseudocyst obstructing the ventriculo-peritoneal shunt in children. Neuroradiology 30(5): 433-438, 1988

Abdominal pseudocyst associated with peritoneal shunt. Case report. Neurologia Medico-Chirurgica 24(9): 722-727, 1984

Peritoneal pseudocyst--ventriculo-peritoneal shunt complications. European Journal of Pediatric Surgery 5(4): 195-197, 1995

Upward dislocation of peritoneal catheter into the ventricular cavity. A rare complication of the ventriculo-peritoneal shunt. Report of a case. Neuropadiatrie 6(3): 313-316, 1975

Rare abdominal complication involving a migrant ventriculo peritoneal shunt tube a case report. Journal of Kyoto Prefectural University of Medicine 97(3): 349-354, 1988

Vulvar migration of the peritoneal end through the inguinal canal in a female infant: An unusual complication of the ventriculo-peritoneal shunt: A case report and review of literature. Journal of Pediatric Neurosciences 8(1): 67-69, 2013

Abdominal complications of ventriculo peritoneal or lumbar peritoneal shunt operation a bowel perforation and historical review. Neurological Surgery 9(1): 81-88, 1981

Distal subgaleal-peritoneal shunt migration into the abdominal wall with subsequent formation of a pre-peritoneal pseudocyst: a rare complication. Journal of Surgical Case Reports 2010(7): 9, 2010

Shunt dysfunction due to calcification of a ventriculo-peritoneal shunt: a case report. Journal of Clinical Neuroscience 11(2): 210-211, 2004

A case of asymptomatic passage per-rectum of a fractured redundant peritoneal catheter from a ventriculo-peritoneal shunt. European Journal of Pediatric Surgery 5(5): 280-281, 1995

A Case of Encapsulated Peritoneal Sclerosis Associated with a Ventriculo-Peritoneal Shunt. No Shinkei Geka. Neurological Surgery 47(2): 211-216, 2019

Tension pneumocephalus following ventriculo-peritoneal shunt. Case report. Neurologia Medico-Chirurgica 26(5): 426-429, 1986

Migration of ventriculo-peritoneal shunt into the chest. Case report. Neurologia Medico-Chirurgica 26(3): 256-261, 1986