CSF ASCITES POST VP SHUNT AFTER 17 YEARS

Cerebrospinal fluid (CSF) ascites following ventriculoperitoneal (V-P) shunting for hydrocephalus is a very rare complication. A 29-year-old male with communicating hydrocephalus and ventriculoperitoneal shunt in-situ, presented with tense ascites. Extensive investigations in the form of complete blood count (CBC), renal function test (RFT), liver function test (LFT), Computerised Tomography (CT) of brain, Contrast Enhanced CT (CECT) of Abdomen, paracentesis was done. Ascitic fluid β2-tranferrin test was positive indicating that the ascitic fluid was indeed CSF, therefore a diagnosis of CSF ascites was made. The patient’s ventriculoperitoneal shunt was converted into a ventriculoatrial shunt. Following the procedure, there has been no refilling of ascites, thus, further confirming the diagnosis of CSF ascites. The aetiology of CSF ascites seems to be some unknown pathological process wherein the peritoneum failed to absorb CSF.