lntrahepatic cerebral spinal fluid pseudocyst: A case report

Abstract

A 5 year old boy presented with shortness of breath, chest pain, and fever for the last few days. He had history of hydrocephalus secondary to aqueduct slenosis diagnosed after birth and ventriculo-peritoneal (V-P) shunt was done for him at age of 6 month. The pregnancy was unremarkable and he delivered by caesarian section at term because of obstructed labor due to large head. The physical examination revealed a toxic child, ill looking, pale, with large head and he was dyspnic with severe chest retraction but no cyanosis. Vital signs: Temperature is 40 C, Respiratory rate is 55 breath / minute, and blood pressure is 75 / 50. Chest examination revealed limitation of movement at the right side of chest, vocal fremitus is diminished, and dullness at right upper and lower chest with diminished air entry at the right side of chest, the trachea was centrally positioned. Auscultation of chest shows diminished breath sounds at right side of chest with fine crackles in both lungs. First and second heart sound were normal. Local examination of the valve of the shunt was poorly functioning with indentation lasting more than 5 minutes. The child was admitted to Tikrit Teaching Hospital (TTH) and send for blood tests, chest X — ray, abdominal ultrasound and CT-scan investigations.