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Subphrenic abscess


Accumulation of pus, limited on one side (above) by the diaphragm, and on the other side (below) by internal organs: stomach, liver, spleen, kidneys, intestines, omentum. There are primary (very rare) and secondary, as a complication of other diseases (cholecystitis, perforated stomach ulcers, pancreatitis, etc.) or after operations on the abdominal organs.
The location of the abscess can be different: in the abdominal cavity and in the retroperitoneal space. Most often, the abscess is located under the right dome of the diaphragm above the liver.
Symptoms and course:
Patients desire pain in the upper abdomen
- right and left hypochondria, epigastric region (under the pit of the stomach). The pains are constant, aggravated by movement. Dry cough, weakness, shortness of breath, fatigue, hiccups are disturbing. The temperature rises to 41 ± C, chills. The general condition is serious, the situation is forced half-sitting
- in the bed. Noteworthy is the lag of the chest during breathing on the sore side. Respiration is rapid, shallow. On palpation of the lower chest in the upper abdomen, pain is noted on the sore side. Percussion observed high standing of the diaphragm, its immobility. Weakening of breathing in the lower parts of the lungs from the affected side, pleural friction noise (when involved in the pleura process), increased voice-trembling.
Recognition:
Diagnostic assistance is provided by additional research methods: radiological and ultrasound.
Treatment:
When forming a subphrenic abscess, one can limit oneself to conservative therapy - antibacterial, detoxification, and infusion. Using punctures in the area of ​​the abscess to introduce antibiotics. Complete cure only after surgery.