Causative micro-organisms of subphrenic abscess are almost similar to that of general peritonitis, though anaerobic organisms slightly dominate.
Symptoms-
1. Past history of localized or generalized peritonitis of the abdomen or some infective focus in the abdomen.
2. Recurring or persistent fever. Fever is typically intermittent in the beginning, and then it becomes progressively more persistent as the abscess matures. The fever is often accompanied with chills and tachycardia.
3. Condition of patient steadily deteriorates.
4. Anorexia.
5. Pain in epigastric region or referred pain to the shoulder of the affected side.
Investigations-
1. Blood test- shows leucocytosis.
2. E S.R. - increased.
3. Blood culture.
4. Straight X-ray of abdomen.
5. Chest X-ray- show pleural effusion.
6. CT scan.
7. Ultrasound.
Management-
1. When suppuration and abscess have formed, surgical intervention is indicated to drain the abscess.
2. Fluid resuscitation, parenteral nutrition for nutritionally depleted patients.
3. Antibiotics.
4. Percutaneous drainage.
5. Operative drainage.
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