脳室腹腔吻合術後の腹腔内嚢腫形成—CT scanおよび超音波による診断

Large Abdominal Pseudocyst as a Complication of Ventriculo-peritoneal Shunt:Diagnosis by Ultrasonography

I．はじめに

　種々の原因によって起こる水頭症に対する外科的療法としての脳室腹腔吻合術（V-P shunt）は現在広く用いられている方法であり，これに付随する腹部合併症も数多く報告されている^1,5,7）．そのうち比較的まれなものとされているものにlarge abdominal pseudocystがある．すでにわれわれは2歳女児の例を報告したが^12），今回28歳の症例を経験した．V-P shuntの合併症としてのlarge abdominal pseudocystの術前診断にultrasonoto-mography, abdominal computed tomographyが有用であったので，若干の文献的考察を加えて報告する．

We report a case in which a large abdominal pseudo-cyst developed following a ventriculo-peritoneal shunt (V-P shunt) for hydrocephalus due to pineal germinoma. A 24-year-old man had undergone a V-P shunt and ra-diotherapy for unbiopsied posterior third ventricle tumor. Four years after operation he was readmitted because of double vision, conjugate upward gaze palsy and a large abdominal mass. Preoperative diagnosis of abdominal pseudocyst was made by abdominal computed tomogra-phy and ultrasonotomography. The shunt tube was clearly demonstrated in the cavity by computed tomogra-phy.