Cerebrospinal Fluid (CSF) Ascites in a Patient with a Ventriculoperitoneal Shunt

 

Clinical features:

(1) The patient has hydrocephalus with placement of a ventriculoperitoneal shunt.

(2) The patient develops ascites.

(3) Other causes of ascites are excluded.

(4) Resolution following revision of the shunt or change to ventriculo-atrial shunt.

 

The CSF may accumulate because of

(1) impaired absorption of fluid. This may be due to chronic peritoneal inflammation and/or mesothelial proliferation caused by the shunt tubing.

(2) excessive CSF production by a disorder of the choroid plexus (papilloma, villous hypertrophy)

 

Differential diagnosis:

(1) loculated collection of CSF (mesenteric fluid entrapment)