Fibrous encapsulation of the peritoneal catheter in peritoneal shunt: Case report

BACKGROUND: The authors report a case of fibrous encapsulation of the peritoneal catheter, which caused peritoneal shunt malfunction, and has not previously been researched well as a complication of peritoneal shunts. CASE DESCRIPTION: A 69-year-old woman who had undergone a lumboperitoneal (LP) shunt for communicative hydrocephalus following subarachnoid hemorrhage caused by a ruptured aneurysm was identified with malfunction of the LP shunt system by dementia and gait disturbance. Hydrocephalus was revealed on computed tomography (CT). Under a laparoscopy, the intraabdominal peritoneal catheter was observed to be obstructed by fibrous encapsulation covering it like a long white stocking. Although the fibrous encapsulating tissue was excised by laparoscopy forceps, a ventriculoperitoneal shunt device was replaced with a new peritoneal catheter. The histopathological diagnosis of the surgically resected encapsulating tissue was the fibrous tissue with a few inflammation cells and a layer of lining cells surrounding some part of it. In the immunohistochemical study, a layer of lining cells surrounding the fibrous tissue showed immunohistochemically positive staining for calretinin. CONCLUSION: The fibrous encapsulation would be formed by peritoneal reaction to a peritoneal catheter as a foreign body by these histopathological and immunohistochemical analyses.