P.140 Illustrated case report: CSF shunt peritoneal catheter obstruction due to omental adhesion and fat stranding

Background: CSF shunt obstruction secondary to omental adhesion alone, without cyst or pseudocyst formation, is rarely reported in the literature. Here we present a case of distal catheter due wrapping with an atypical presentation failure. CT imaging demonstrated stranding. The shut revision was entirely laparoscopic. supplemented intraoperative images. Methods: Chart review and literature search. Results: 33-year-old female right-sided cystoperitoneal for posterior fossa arachinoid who presented ED picture surgical abdomen suggestive acute cholecystitis. Interestingly, this patient had gallbladder removed year ago. showed non-specific findings fat stranding around tip catheter. Although no headache any neurological symptoms, brain done increase size. Diagnostic laparoscopy Intraoperative active role aetiology malfunction. After adequate adhesiolysis, noted be working dripping repositioned into peritoneal cavity. Conclusions: Shunt malfunctions omentoperitoneal but may fact under-recognized. This requires high index suspicion especially equivocal imaging.