Case of the Week: March 24-March 31, 2011

9 year old with ventriculo peritoneal shunt

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Case Details

Plain film of the abdomen shows soft tissue fullnees in the pelvis. Ultrasound confirmed large fluid collection of CSF with shunt in the middle of the collection


Diagnosis: CSF-oma

CSF-oma is a loculation of cerebrospinal fluid (CSF) at the distal end of the Ventriculoperitoneal shunt tube.


It may occur secondary to adhesions and results in an enlarging abdominal and or /pelvic mass at the catheter tip, as CSF from the tip is no longer absorbed by the peritoneum.


CSF-oma can resolve spontaneously or after shunt revision or repostion.


Complications include infection and obstruction.


Infection rate is 30% and can be higher in younger children.


Causes of Shunt Malfunction:

Mechanical failure of the shunt




Equipment failure

Fracture of tubing


Shunt infection

  Locations of Shunt Catheter Migration:


Internal jugular vein









Coronary sinus

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    VCU Department of Pediatric Radiology Virginia Commonwealth University VCU Medical Center