CSFoma
Peritoneal Cerebrospinal Fluid Pseudocyst

General Considerations

• Loculation of cerebrospinal fluid (CSF) at the distal end of the a ventriculoperitoneal shunt tube
• May occur secondary to adhesions
• Leads to an enlarging abdominal and/or pelvic mass at catheter tip
• CSF from tip is no longer absorbed by peritoneum

Clinical Findings

• Local signs of  an abdominal mass
• Increased intracranial pressure signs

Imaging Findings

• Diagnosis is most often made by ultrasound
  • Sonolucent mass
• Up to 2 liters of fluid

Treatment

• Can resolve spontaneously
• Shunt revision and repositioning
• Aspiration of cyst’s contents

Complications

• Infection of pseudocyst can reach >76% in children under 4 years
• Overall infection rate is 30%

CSFoma. CT scan of lower abdomen at left shows a large fluid-filled cystic mass (black arrow) at the termination of the coiled ventriculoperitoneal shunt tube (red arrows) seen traversing the chest in the chest radiograph at right (white arrows).
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Radiology of the Postoperative GI Tract

By Bruce R. Javors, Ellen L. Wolf

Edition: illustrated

Published by Springer, 2003