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Subphrenic abscess

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The space between the diaphragm, which separates the chest cavities from the abdominal cavity, and the transverse colon is called the "subphrenic space". If there is an abscess developing in this space, this is called a subphrenic abscess. As there is a right and a left chest cavity, there can be from an anatomical point of view a right-sided and a left-sided subphrenic abscess. | Subphrenic abscess 1. Introduction The space between the diaphragm which separates the chest cavities from the abdominal cavity and the transverse colon is called the subphrenic space . If there is an abscess developing in this space this is called a subphrenic abscess. As there is a right and a left chest cavity there can be from an anatomical point of view a right-sided and a left-sided subphrenic abscess. 2. Aetiology Subphrenic abscesses are localised collections of pus usually underneath the right or left hemi- diaphragm. Other sites include the lesser sac - beneath the liver - and in the hepato-renal pouch. They are usually the result of a breach in the integrity of the peritoneum. Subphrenic abscesses are the commonest intra-abdominal abscess. 3.Subphrenic abscesses may occur as the result of generalised peritonitis following acute appendicitis perforated peptic ulcer perforated gallbladder producing a right-sided subphrenic abscess and biliary surgery bowel surgery and subsequent peritoneal faecal contamination Other causes include infection of a haematoma for example after splenectomy. 4. Clinical features The clinical picture of a subphrenic abscess is one of a patient who develops features of toxicity 2 to 21 days after making an initial recovery from an episode of peritonitis or an operation these features are