Abstract
Here, we report a rare complication of a cerebrospinal fluid pseudocyst in the greater omentum in a girl with a ventriculoperitoneal (VP) shunt. The girl had undergone VP shunt placement when she was an infant, for hydrocephalus due to meningomyelocele. When she was 2 years old, she complained of sudden abdominal distension and frequent vomiting. Abdominal computed tomography (CT) revealed the presence of a giant simple cystic lesion ; the tip of the V-P shunt tube was located in this lesion. The patient underwent a laparoscope-assisted operation through a small incision at the site of the previous wound. We inserted an S.A.N.D. balloon (Hakko Co. Ltd.) into the cyst, and 1,420 ml of clear watery fluid that was confirmed to be cerebrospinal fluid was absorbed by the ballon. Laparoscopy revealed that the V-P shunt had penetrated to the great omentum. We diagnosed the patient as having a cerebrospinal fluid pseudocyst in the omentum and performed laparoscopic fenestration of the omentum. The patient repeatedly developed a cerebrospinal fluid pseudocyst and underwent ventriculoatrial shunt placement at 5 months after surgery. She is now undergoing follow-up treatment and has not developed any complications.
