Abstract
We report a case of intraabdominal complications due to three ventriculoperitoneal (VP) shunt tubes required conservative therapy followed by laparotomy. A 29-year-old female who had three VP shunt tubes (inserted at the ages of 0, 12, and 28, respectively) developed right lower abdominal pain 10 months after the last insertion. Abdominal CT revealed a shunt tube at the right lower abdomen without apparent appendicitis. The pain subsided by conservative therapy, however, laparotomy was necessary due to the symptom of increased intracranial pressure and intraabdominal fluid collection suggestive of a pseudocyst. Two old tubes which were obstructed with fibrous adhesion were removed, and the latest one was seen in the pseudocyst. Despite the repositioning of the tube in the abdominal cavity, another pseudocyst occurred and the tube was repositioned again. Finally, she needed extraventricle drainage and ventriculoatrial shunt. There have been no previous reports of pseudocysts with three VP shunt tubes, which had been placed for 29 years and all of which were in trouble in the abdominal cavity like in this case.
