Drainage of Subphrenic Abscess

Abstract

Although subphrenic abscesses may arise from primary infections of the biliary tract, the appendix, or the colon, in the great majority of cases subphrenic sepsis follows a previous abdominal operation. In DeCosse, Poulin, Fox, and Condon’s study of 52 patients in whom subphrenic sepsis followed previous surgery, 22 of them developed abscesses subsequent to operations on the stomach and 11 of them, abscesses after biliary tract surgery. Other causes of subphrenic abscesses included surgery for trauma in 7 patients and colon operations in another 7 cases. These authors felt that postoperative bleeding was a common contributing cause in their series of subphrenic abscesses, many of which were, in fact, infected hematomas. Inadvertent splenectomy was another postoperative complication associated with left-sided subphrenic sepsis following gastric surgery.