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Review article
DOI: 10.1016/j.neucie.2020.08.004
Available online 10 September 2020
Abdominal pseudocysts, an unusual complication of ventriculoperitoneal shunt systems: Literature systematic review
Pseudoquistes abdominales, una complicación rara de los sistemas de derivación ventrículo-peritoneal: revisión sistemática de la literatura
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Andoni García-Martín
Corresponding author
andonigarciam@gmail.com

Corresponding author.
, Alvaro Otero-Rodríguez, David Miranda-Zambrano, Daniel Angel Arandia-Guzmán, Luis Torres-Carretero, Pablo Sousa-Casasnovas, Daniel Pascual-Argente
Servicio de Neurocirugía, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
Received 18 June 2019. Accepted 18 March 2020
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Abstract

Since the first report in 1954, abdominal pseudocysts have been recognized as a particularly uncommon complication of ventriculoperitoneal shunts of CSF, so their etiology, diagnosis, and therapeutic management remain very controversial.

Our objective is to offer a critical and updated systematic review of those controversial points, using a thorough search and review of the most relevant literature available.

The clinical presentation of pseudocysts is normally through non-specific abdominal symptoms. The most validated etiology consists on the existence of a concomitant infection of the CSF shunt system, and so, treatment needs of antibiotherapy and total or partial substitution of the system. However, the pseudocyst itself doesn’t need an active treatment, except for some specific cases. This management, algorithmically presented in the present work, achieves a lower recurrence rate than other options, but this one is still important, and is also associated with other complications of those shunts related with several other factors which need to be taken in account.

Keywords:
Abdominal pseudocyst
Ventriculoperitoneal shunt
Infection
Etiology
Management
Resumen

Los pseudoquistes abdominales son una complicación infrecuente de las derivaciones ventrículo-peritoneales de LCR, por lo que su etiología, diagnóstico y manejo terapéutico son muy controvertidos.

Nuestro objetivo es ofrecer una revisión sistemática, crítica y actualizada, de la complicación, valiéndonos de una búsqueda y revisión de la literatura más relevante existente a propósito de dicho tema.

La forma de aparición de los pseudoquistes es generalmente mediante clínica abdominal muy inespecífica. La etiología más validada es la existencia de una infección concomitante del sistema de derivación del LCR, y como tal el tratamiento precisa antibioterapia y sustitución de todo o parte del sistema. Sin embargo, el pseudoquiste no necesita de un tratamiento activo, salvo casos concretos. Este manejo, presentado algorítmicamente en el presente trabajo, logra una tasa de recurrencia menor que otras opciones que, no obstante, sigue siendo importante, y se asocia además a otras complicaciones de las derivaciones relacionadas con varios factores.

Palabras clave:
Pseudoquiste abdominal
Derivación ventrículo-peritoneal
Infección
Etiología
Manejo

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