Intrahepatic Cerebrospinal Fluid Pseudocyst: A Case Report and Systematic Review.

Abstract

Perforation of a solid visceral organ and subsequent development of a cerebrospinal fluid pseudocyst is a rare complication of ventriculoperitoneal shunts. A patient with a history of global developmental delay presented with shunt failure secondary to an intrahepatic cerebrospinal fluid pseudocyst. The diagnosis had not been initially apparent owing to the absence of ventriculomegaly or a palpable abdominal mass and/or tenderness. Following diagnosis on abdominal imaging, the pseudocyst was aspirated, and the ventriculoperitoneal shunt was successfully revised. A series of 22 cases of previously reported intrahepatic pseudocysts and abscesses is presented, and the putative mechanisms that have been put forward to explain the development of these collections are discussed. Review of the literature demonstrates that several techniques have been successfully employed in the management of this complication.