Eclectic drainage of subphrenic abscesses

Laparoscopic drainage of right subphrenic abscess: report of one case

Laparoscopic surgery has proven to be a very useful technique. Subphrenic abscess, although a rare entity, occurs in the majority of the cases in association with gastroduodenal and biliary disease, appendicitis, or following abdominal surgery. We present the case of a 45-year-old male with a right subphrenic abscess that was successfully treated by laparoscopy. Laparoscopic drainage of subphrenic abscess should be considered as an alternative modern option when dealing with this problem.

Factors influencing the treatment of intra-abdominal abscesses

Forty-eight consecutive patients with 68 intra-abdominal abscesses who had operative or radiologic attempts at drainage were analyzed. Patients who had radiologic drainage were older and had simple abscesses more often. Simple abscesses were treated successfully in a high percentage of patients using both operation and radiologic drainage. Mortality was higher for patients with complex abscesses, and most of these patients required operative treatment. Successful abscess resolution was eventually achieved in 79 percent of patients.

Is "primary" subphrenic abscess caused by Streptococcus milleri a result of unrecognized gastrointestinal perforation?

An unusual case of subphrenic abscess presenting as empyema of the pleural cavity is described. The abscess developed secondarily to an occult perforation of the gastrointestinal tract, which was, diagnosed indirectly by the discovery of a fishbone within the abscess. Isolation of Streptococcus milleri from the pus was an important clue for the existence of an underlying gastrointestinal pathology.