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KMID : 0371319710130080035
Journal of the Korean Surgical Society
1971 Volume.13 No. 8 p.35 ~ p.42
Subphrenic Abscess
Chang Jeon-Won

Suh Sang-John
David J. Seel
Abstract
This report is a study of 52 cases of subphrenic abscess treated surgically at Chon-Ju Presbyterian Medical Center from 1966 to March, 1971.

1. Twenty four cases of subphrenic abscess were developed following surgery. (The most common causes were among the gastric and duodenal surgery.) Twenty eight cases were developed among the non surgical patients. (Ruptured liver abscess were the most common cases.)
2. The incidence of subphrenic abscess following the surgery of stomach and duodenum was 1.33%, biliary tract 0.86%, and appendix 1.85%.
3. Subhrenic spaces were divided as right suprahepatic, right subphrenic, left subhrenic, and lesser sac space.
4. The most important diagnostic criteria were history of surgery in past, tenderness, fever, leukocytosis, and X-ray finding of pleural effusion, elevation of diaphragm, fluid level and pulmonary change, etc.
5. The most common pathogenic organisms were Escherichia coli, Staphylococci, and Streptococci.
6. The types of drainage used were depent on the position of the abscess; transpleural approach for right suprahepatic abscess, subcostal abdominal approach for righ subphrenic and left subphrenic abscess. and posterior extraperitoneal approach was used for the abscess of subhepatic space at the posterior site.
7. The over all mortality of 52 operated cases was 11.7%. The mortality rate was higher among the cases who had following complication; septicemia, pulmonary empyema, perotonitis, and cachexia.
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