Subphrenic abscess

Subphrenic abscess
Perforated cholecystitis with subphrenic abscess. Patient is an elderly female with a 2 month history of abdominal pain with a recent hospital admission for septicemia and ARDS. Large subphrenic abscess with also subhepatic abscesses likely the result of perforated complicated cholecystitis. Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

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Overview

Subphrenic abscess is a localized infection between the colon and the diaphragm on the left side of the abdomen and the liver and the diaphragm on the right side of the abdomen.

They may occur following rupture of any organ in the abdomen or following any diagnostic (e.g laparoscopy) and surgical procedures in the abdomen.

Differential diagnosis of underlying causes

• Blunt or penetrating traumas
• Surgical procedures
• Infections
• Tumors or ulcers that lead to rupture of abdominal organs.

Signs and Symptoms

• Fever
• Chills
• Upper abdominal pain
• Difficulty in breathing and painful breathing.
• Shoulder pain (due to irritation of the diaphragm)

Diagnostic Findings

Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

• 

  Perforated cholecystitis with subphrenic abscess. Patient is an elderly female with a 2 month history of abdominal pain with a recent hospital admission for septicemia and ARDS. Large subphrenic abscess with also subhepatic abscesses likely the result of perforated complicated cholecystitis.

• 

  Perforated cholecystitis with subphrenic abscess.

• 

  Perforated cholecystitis with subphrenic abscess.

• 

  Perforated cholecystitis with subphrenic abscess.

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  Perforated cholecystitis with subphrenic abscess.

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  Perforated cholecystitis with subphrenic abscess.

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  Perforated cholecystitis with subphrenic abscess.

Pathological Findings

Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

• 

  Spleen: Subphrenic Abscess: Gross good example fibrinopurulent exudate on capsule

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  Spleen: Subphrenic Abscess: Gross spleen capsule coated with green pus