Investigation of possible VP-shunt-related pseudocyst reveals shunt erosion into small bowel

Posted By Kelsey Bourm
Investigation of possible VP-shunt-related pseudocyst reveals shunt erosion into small bowel

Our patient is an 8-year-old female with a past medical history of cerebral palsy and ventriculoperitoneal shunt who presented with a 2-day history of nonbilious emesis, fever, and cephalgia. The CT head on admission demonstrated ventriculomegaly which had increased since the prior CT examination. A subsequent nuclear medicine shuntogram verified patency of the distal shunt tubing, however, there was central organization of the radiotracer in the abdomen in a pattern commonly seen with pseudocyst formation. The follow-up CT of the abdomen and pelvis revealed that the shunt tubing was now intraluminal within multiple small bowel loops. This finding was verified surgically. The VP shunt fluid analysis revealed gram-negative bacteria.

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