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KMID : 0371319680100040205
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Journal of the Korean Surgical Society
1968 Volume.10 No. 4 p.205 ~ p.215
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A Clinical Review of Subphrenic Abscess
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朴永寬/Park, Young Kwan
崔昌錄/Sibley, J.R./李鐵/Choi, Chang Rok/--/Lee, Chul
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Abstract
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A clinical study of 12 cases of subphrenic abscess, treated in Presbyterian Hospital, Taegu, Korea between 1960 and 1967, is presented. English speaking Medical literatures on the subject are briefly reviewed, and analysis of important clinical symptoms and signs together with means of surgical drainage is made.
1. In ten cases subphrenic abscess developed following surgery for various primary conditions, and in one case it occured after sustaining a blunt trauma to the abdomen. The predisposing cause in the remainderrof the cases was unknown.
2. The ratio between male and female was 2:1, average age 37.4 years, and the prevalent age range was 40.
3. Chief complaints of the cases studied were intermittent high fever, upper abdominal pain, nausea, and fullness in the upper abdomen.
4. In seven cases, the white cell count was above 10,000/cu.mm, and in the remainder of the cases it was within normal range.
5. Important X-ray findings were pleural effusion, elevation of the diaphragmatic hemisphere, limitation or absence of the diaphragmatic movement on fluoroscopy, and subphrenic or intraabdominal free air with fluid level.
6. Results of microbiological study were as follows:
Single infection....................10
Mixed infection.....................2
7. Distribution of location:
Right side involvemet seven, left side four and bilateral involvement one.
8. Various approaches used for surgical drainage
a. Extraperitoneal route used in eight cases,
b. Transperitoneal route used in four cases.
The latter approach appears to be a direct one and shortest distance to reach and easier one to perform, and also it seems to be accompanied by less postoperative morbidity and higher success rate than the former.
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