A subphrenic abscess is a buildup of pus and other body fluids in an area of the abdomen called the subphrenic space, positioned between the diaphragm and the colon. This medical condition is most commonly the result of a surgical procedure in the abdomen or a perforated ulcer or infection. It is treated with surgery to drain the fluid and antibiotics to address infection. Patients with this condition are most commonly older adults, although a subphrenic abscess can occur in patients of any age.
This condition occurs when infectious material is released into the subphrenic space, where it can float freely and travel as the contents of the abdomen move. After either exploratory or therapeutic surgical procedures, it is possible for an infection to develop and turn into a subphrenic abscess. These abscesses can also occur when a patient with a severely inflamed gallbladder or appendix experiences a rupture, when an anastomosis in the bowel ruptures, or when an ulcer in the stomach perforates through to the abdomen.
Patients can develop symptoms like tenderness and pressure in the abdomen, fever, restlessness, nausea, fatigue, and a feeling of general malaise. The subphrenic abscess will be clearly visible on medical imaging studies like ultrasounds and X-rays, and the abdomen may also feel tender to the touch. If the patient is unstable, medications may be prescribed to get the patient healthy enough for surgery. Once the patient is stable, a surgeon opens up the site of the abscess, drains the material, irrigates it, and implants a tube.
The tube will allow additional pus and other materials to drain as the subphrenic abscess heals. During the surgery, the surgeon will also address the cause of the abscess, performing a repair or removal as needed to stop the buildup of infected material. When the patient wakes up, antibiotics will be administered to address infection, and the tube's output will be monitored as material drains. As the patient heals, the tube will be gradually shortened, until it can be removed altogether.
Subphrenic abscess is one of the possible risks of abdominal surgery, and it is a potential complication of untreated inflammation, infection, and ulceration in the abdomen. Patients at risk for this condition may be advised to monitor their health carefully for any signs of emerging complications. This will allow issues like a subphrenic abscess to be addressed as quickly as possible, ideally before the patient's health has been permanently compromised.