The accumulation of pus, limited on the one hand (above) by the diaphragm, and on the other hand (below) by the internal organs: stomach, liver, spleen, kidneys, intestines, large omentum. There are primary (very rare) and secondary, as a complication of other diseases (cholecystitis, perforated gastric ulcer, pancreatitis, etc.) or after operations on the abdominal organs.
Localization of the abscess may be different: in the abdominal cavity and in the retroperitoneal space. Most often, an abscess is located under the right dome of the diaphragm above the liver.
Symptoms and course:Patients desire upper abdominal pain.
- right and left hypochondria, epigastric region (under the spoon). Constant pain, aggravated by movement. Worried dry cough, weakness, shortness of breath, fatigue, hiccups. The temperature rises to 41 ± C, chills. The general condition is grave, a forced semi-sitting position
- in bed. Note the lagging of the chest when breathing on the affected side. The breathing is rapid, superficial. On palpation of the lower parts of the chest in the upper abdomen there is pain on the affected side. Perkutorno there is a high standing of the diaphragm, its immobility. Weakening of respiration in the lower parts of the lungs from the affected side, pleural friction noise (with involvement of the pleura in the process), increased vocal tremor.
Recognition:Assistance in the diagnosis of additional research methods provide: radiological and ultrasound.
Treatment:When forming the subdiaphragmatic abscess, it is possible to confine to conservative therapy - antibacterial, detoxification, infusion. With the help of puncture in the region of the abscess to enter antibiotics. Complete cure, only after surgery.