PMC4235115_01
(a) Computed tomography (CT) on admission revealing the dilatation of bilateral ventricles and the bilateral periventricular lucency (b) Shuntgraph revealing the peritoneal catheter tip (arrow) was obstructed
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F1
Hydrocephalus was diagnosed by computed tomography (CT) [Figure 1a] and the malfunction of VP shunt due to the obstruction of the peritoneal catheter was revealed by shuntgraphy [Figure 1b].
(a) The peritoneal catheter tip was obstructed by a fibrous capsule like a thin membranous stocking. (b) The fibrous capsule was formed from the proximal slit (arrow) to the tip of the peritoneal catheter. (c) The white fibrous capsule was stripped off by laparoscopy forceps. (d) Two pieces of intraluminal granulomas (arrows), (e) Colorless clear cerebrospinal fluid (CSF) flowed out after the removal of the fibrous capsule. (f) The white fibrous capsule like a sock of the peritoneal catheter tip. (g) Colorless clear CSF flowed out after the removal of the fibrous capsule
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F2
Laparoscopy was performed and the peritoneal end of the catheter was obstructed by a fibrous glossy white capsule, which covered it like a sock [Figure 2f]. Even though partial peritoneum was adhered, this fibrous capsule was excised by laparoscopy forceps without the exchange of a new peritoneal catheter [Figure 2g].
(a) Photomicrograph of the surgical specimen in case 1 showing peritoneal tissue composed by a layer of mesothelium cells and fibrous tissue. (H and E, x200) (b) Photomicrograph of the surgical specimen in case 2 showing hyalinization of membranous tissue surrounded by fibrous tissue. (H and E, x400)
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F3
This capsule was pathologically diagnosed hyalinization of membranous tissue surrounded by fibrous tissue [Figure 3b].
PMC4235115_02
(a) The peritoneal catheter tip was obstructed by a fibrous capsule like a thin membranous stocking. (b) The fibrous capsule was formed from the proximal slit (arrow) to the tip of the peritoneal catheter. (c) The white fibrous capsule was stripped off by laparoscopy forceps. (d) Two pieces of intraluminal granulomas (arrows), (e) Colorless clear cerebrospinal fluid (CSF) flowed out after the removal of the fibrous capsule. (f) The white fibrous capsule like a sock of the peritoneal catheter tip. (g) Colorless clear CSF flowed out after the removal of the fibrous capsule
SNI-5-451-g002.jpg
PMC4235115_02_SNI-5-451-g002.jpg
F2
Laparoscopy was performed and the peritoneal end of the catheter was obstructed by a fibrous glossy white capsule, which covered it like a sock [Figure 2f]. Even though partial peritoneum was adhered, this fibrous capsule was excised by laparoscopy forceps without the exchange of a new peritoneal catheter [Figure 2g].
(a) Photomicrograph of the surgical specimen in case 1 showing peritoneal tissue composed by a layer of mesothelium cells and fibrous tissue. (H and E, x200) (b) Photomicrograph of the surgical specimen in case 2 showing hyalinization of membranous tissue surrounded by fibrous tissue. (H and E, x400)
SNI-5-451-g003.jpg
PMC4235115_02_SNI-5-451-g003.jpg
F3
This capsule was pathologically diagnosed hyalinization of membranous tissue surrounded by fibrous tissue [Figure 3b].