A patient with a ventriculoperitoneal shunt may develop cerebrospinal fluid (CSF) ascites.
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)
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Specialty: Gastroenterology