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KMID : 0378019740170040531
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New Medical Journal
1974 Volume.17 No. 4 p.531 ~ p.536
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Subphrenic Abscess
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Abstract
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1. Clinical observation was made on 35 cases of subphrenic abscess treated surgically at the department of surgery, the Presbyterian Medical Center, Chonju, Korea, from Mar. 1955 to Apr. 1966.
2. The 35 cases in this series included 26 males and 9 females, giving a ratio of 3 to 1. The ages
ranged from 9 to 63 years and nearly half of the cases were in their 4th decade.
3. Subphrenic abscess developed as a complication of a surgical procedure in 18 cases; operations
on the stomach, duodenum and billiary tract accounted for about half of the cases.
In the remained 17 non-preoperative cases, hepatobilliary disease accounted for two thirds of the
cases, and amebic liver abscess was the leading cause of the hepatobilliary disease.
4. The interval from the onset of symptoms until surgical drainage was 5days to 14 months.
Nine cases of the 21 well recovered cases after surgery had operations within 20 days after the onset of symptoms.
5. Bacteriologic studies of abscess was made in 33 cases; positive in 29 cases, negative in 4 cases (12%). Mixed infection was noted in 16 cases(49%). Staphylococcus, Streptococcus and E. coli were tqe most prevalent organisms.
6. Surgical approaches were as follows, Transperitoneal 20 cases. Extraserous 13 cases, and transpleural 2 cases.
7. Complications were ranged widely and the most frequent in pleural effusion (23 cases). No complication was noted in 4 cases(11 % ).
8. Pus drainage after surgery ranged 7 to 74 days. The average was 25 days.
9. Of the 35 subphrenic cases. 21 cases (60%) were healed, 7 cases (20%) died during treatment and 7 cases were discharged in moribund state or against advice.
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