Subphrenic Abscess

Excerpt

Subphrenic abscesses represent infected collections bounded above the diaphragm and below by the transverse colon, mesocolon, and omentum. Described by Barlow in 1845, Von Volkman recorded the first surgical cure in 1879 through abdominal and thoracoscopic exploration. Usually, subdiaphragmatic abscesses arise from abdominal surgery, trauma, or local inflammation in the space between the liver, intestines, and lungs, making drainage a challenge. The diagnosis of subphrenic abscess can be difficult, and hence, it is known by the famous aphorism: 'pus somewhere, pus nowhere else, pus under the diaphragm.'