Analysis of pleural effusion & subphrenic abscess in the case of abdominal surgery

The authors report the radiographic findings in 13 cases of subphrenic abscess complicating abdominaloperations at Severance Hospital, Yonsei Medical Center. Radiographic diagnosis is important because clinicalfeatures may be masked when a patient is receiving antibiotic for presumed sepsis elsewhere. 1. There were 13cases of subphrenic abscess after 670 abdominal operations (1.9%). 2. The post-operative subphrenic abscessincidence was 3.2% following gastrectomy, 2,9% after small bowel operations, 1.2% following cholecystectomy, 1.0%after appendectomy, and 1.3% each after operations on the colon and uterus. 3. The most common radiographicfindings on subphrenic abscess were pleural effusion and elevation of diaphragm or decreased diaphragmaticmovement during fluoroscopy; others include abnormal air shadow in abscess cavity, linear atelectasis in lungbase, displacement of stomach fundus or colon. 4. There were 21 pleural effusion following 670 abdominaloperations (3.1%), 10 of which occurred in patients subsequently proven by drainage to have a subphrenic abscess.