Subphrenic Abscess

What is a subphrenic abscess?

A subphrenic abscess is a collection of pus in the space between the diaphragm and the transverse colon. It typically develops 3 to 6 weeks following surgery in the abdomen such as biiary, appendix surgery or surgery on the stomach or duodenum.

Fifty percent of cases occur on the right side, 25% occur on the left side, and the remaining 25% occur in both sides simultaneously.

What are the signs and symptoms o a subphrenic abscess?

Patients with a subphrenic abscess are often elderly. Some or all of the following signs and symptoms may be present:
• Fever;
• Loss of appetite approximately one month after surgery;
• Non-productive cough;
• Abdominal pain (on the affected side);
• Leukocytosis and lack of red blood cells (anemia) appear on blood test); and
• Abscess cavity with gas in it and lung abnormalities appear on abdominal X-ray.

How is a subphrenic abscess diagnosed?

A physician may use physical examination, X-rays, ultrasounds, blood tests, and CT scans to make a diagnosis.

How is a subphrenic abscess treated?

Like any other abscess in the body, a subphrenic abscess needs to be drained and the infection needs to be treated with appropriate antibiotics. This can be a complex undertaking with a subphrenic abscess. Drainage can be done through surgery or a drainage catheter. The patient’s nutritional status should be monitored, as these patients are often malnourished.

Other complications can be clots in the leg veins or the portal system veins, which may have to be treated with heparin and Coumadin. The overall mortality rate is about 35% despite the best therapy.

There is also an FDA-approved non-drug method available, IceWave patches from Lifewave, which will control pain.