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Subphrenic Abscess

Alicia H. Vinyard, DO Reviewed 06/2018
 


BASICS

  • A complicated abdominal infection below the diaphragm

  • Synonym(s): sub- or infradiaphragmatic abscess

DESCRIPTION

The subphrenic space is a peritoneal space on each side of the falciform ligament, ...

DIAGNOSIS

Early diagnosis reduces morbidity and mortality. 

HISTORY

  • Recent abdominal surgery

  • Constitutional symptoms: fever, chills, diaphoresis, malaise

  • Pain symptoms: chest, shoulder (referred pain—Kehr...

TREATMENT

  • Control source (percutaneous or surgical drainage of the abscess) and correct any ongoing contamination (repair of leaking anastomosis or perforation); keep NPO until source identified.

  • Broad...

ONGOING CARE

DIET

Patients without evidence of anastomotic leak, fistula, or peritonitis can typically continue a regular diet. 

PROGNOSIS

  • Morbidity and mortality vary depending on underlying comorbiditi...

REFERENCES

1
Mazuski JE, Solomkin JS. Intra-abdominal infections. Surg Clin North Am.  2009;89(2):421–437. [View Abstract on OvidMedline]
2
Solomkin JS, Mazuski JE, Bradley JS, et al. Diagnosis and ...

CODES

ICD10

  • K65.1 Peritoneal abscess

  • T81.4XXA Infection following a procedure, initial encounter

ICD9

  • 567.22 Peritoneal abscess

  • 998.59 Other postoperative infection

SNOMED

  • 52478002 subdiaphragmatic abscess (...

CLINICAL PEARLS

  • Subphrenic abscesses are due to contamination of the sterile peritoneal cavity with GI tract bacteria.

  • Proper management involves determining the source of the infection, identifying th...

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