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DictionarySeeabscessSubphrenic Abscess
Subphrenic Abscess an accumulation of pus, often with gas, under the diaphragm; a complication from acute inflammatory diseases of the organs of the abdominal cavity, including appendicitis, cholecystitis, and perforated ulcer of the stomach or duodenum, or from traumatic injuries to the organs accompanied by peritonitis. Subphrenic abscess is one of the more frequent occurrences of what are called residual intra-abdominal abscesses. More rarely observed are extraperitoneal subphrenic abscesses, located between the diaphragm and the diaphragmatic peritoneum—a complication of retroperitoneal phlegmon or paranephritis. Subphrenic abscess is manifested by fever, chills, and pains in the thorax and the hypochondrium on the affected side. There is often an accumulation of exudate in the pleural cavity. X-ray data, which are important in diagnosing subphrenic abscess, include limitation of mobility of the cupula of the diaphragm and the fact that it stands high and the presence of gas with a level of fluid under the diaphragm. The only treatment is surgical. Preventative measures consist in early diagnosis and surgical treatment of diseases that can lead to the condition. V. A. PENIN subphrenic abscess
sub·phren·ic ab·scessan abscess directly beneath the diaphragm. Synonym(s): subdiaphragmatic abscessabscess (ab'ses) [L. abscessus, a going away] ANTECUBITAL ABSCESS: Antecubital abscess opened to allow drainage of infectionA localized collection of pus in any body part, resulting from invasion of a pyogenic bacterium or other pathogen. Staphylococcus aureus, e.g., methicillin-resistant S. aureus (MRSA), is a common cause. The abscess is surrounded by a membrane of variable strength created by macrophages, fibrin, and granulation tissue. Abscesses can disrupt function in adjacent tissues and can be life threatening in some circumstances, e.g., in the lung or within the peritoneal cavity. illustration; inflammation; pus; suppuration; ACUTE ABSCESSacute abscessAn abscess associated with significant inflammation, producing intense heat, redness, swelling, and throbbing pain. The tissue over the abscess becomes elevated, soft, and eventually unstable (fluctuant) and discolored as the abscess comes to a head (points). An abscess can rupture spontaneously or be drained via an incision. If it is left untreated, the pathogens may spread to adjacent tissues or to other parts of the body via the bloodstream. Appearance of or increase in fever may indicate sepsis. illustrationalveolar abscessAn abscess around the root of a tooth in the alveolar cavity. It is usually the result of necrosis and infection of dental pulp following dental caries. See: periapical abscessamebic abscessAn abscess caused by Entamoeba histolytica. Synonym: endamebic abscessanorectal abscessAn abscess in the ischiorectal fossa. It may occur in patients with Crohn disease, diabetes mellitus, or anal fissures more often than in other patients. Incision, drainage, and antibiotics usually provide effective treatment. Synonym: rectal abscess; Synonym: ischiorectal abscessapical abscess1. An abscess at the apex of a lung.2. Periapical abscess.appendicular abscessAn abscess around an inflamed or ruptured vermiform appendix.axillary abscessAn abscess or multiple abscesses in the axilla, e.g., in patients with hidradenitis suppurativa.Bartholin abscess See: Bartholin, Caspar (the younger)bicameral abscessAn abscess with two pockets.bile duct abscessAn abscess of the bile duct. Synonym: cholangitic abscessbiliary abscessAn abscess of the gallbladder. It is an infrequent complication of cholangitis or obstruction of the bile duct. bone abscessBrodie abscess.brain abscessAn intracranial abscess involving the brain or its membranes. It is seldom primary but usually occurs secondary to infections of the middle ear, nasal sinuses, face, or skull or from contamination from penetrating wounds or skull fractures. It may also have a metastatic origin arising from septic foci in the lungs (bronchiectasis, empyema, lung abscess), in bone (osteomyelitis), or in the heart (endocarditis). Infection of nerve tissue by the invading organism results in necrosis and liquefaction of the tissue, with edema of surrounding tissues. Brain abscesses may be acute, subacute, or chronic. Their clinical manifestations depend on the part of the brain involved, the size of the abscess, the virulence of the infecting organism, and other factors. Synonym: cerebral abscess; intracranial abscessSymptomsSymptoms may include headache, fever, vomiting, malaise, irritability, seizures, or paralysis. TreatmentThe usual treatment is chemotherapy. Surgical drainage may be required. breast abscessMammary abscess.Brodie abscess See: Brodie, Sir Benjamin Collinsbursal abscessAn abscess in a bursa.canalicular abscessA breast abscess that discharges into the milk ducts.caseous abscessAn abscess in which the pus has a cheesy appearance. cerebral abscessBrain abscess.cholangitic abscessBiliary abscess.chronic abscessAn abscess with pus but without signs of inflammation. It usually develops slowly as a result of liquefaction of tuberculous tissue. It may occur anywhere in or on the body but more frequently in the spine, hips, genitourinary tract, and lymph glands. Symptoms may be very mild. Pain, when present, is caused by pressure on surrounding parts; tenderness is often absent. Chronic septic changes accompanied by afternoon fever may occur. Amyloid disease may develop if the abscess persists for a prolonged period. Synonym: cold abscesscircumtonsillar abscessPeritonsillar abscess.cold abscessChronic abscess.collar-button abscessesTwo pus-containing cavities, one larger than the other, connected by a narrow channel.dental abscessAn acute inflammatory infection within the maxilla or mandible. See: periapical abscess; periodontal abscessdentoalveolar abscessPeriapical abscess.diffuse abscessAn abscess not circumscribed by a well-defined capsule.dry abscessAn abscess that disappears without pointing or breaking.embolic abscessMetastatic abscess.emphysematous abscessAn abscess containing air or gas, produced by organisms such as Clostridium perfringens. Synonym: gas abscess; tympanitic abscessendamebic abscessAmebic abscess.epidural abscessExtradural abscess.extradural abscessAn abscess on the dura mater, an occasional cause of back pain in febrile patients, usually in those who inject drugs. Synonym: epidural abscessfecal abscessAn abscess containing both pus and stool. Synonym: stercoraceous abscess; stercoral abscessfilarial abscess An abscess caused by parasitic infection with microfilariae.follicular abscessAn abscess in a follicle.fungal abscessAn abscess caused by a fungus, e.g., mycetoma. Synonym: mycotic abscessgas abscessEmphysematous abscess.gingival abscessAn abscess of the gum.helminthic abscessWorm abscess.hemorrhagic abscessAn abscess containing blood.hepatic abscessLiver abscess.hot abscessAcute abscess.hypostatic abscessMetastatic abscess.idiopathic abscessAn abscess of unknown cause.iliac abscessAn abscess in the iliac region.iliopsoas abscessAn abscess in the psoas and iliacus muscles. It typically results from a local or regional spread of an intestinal or renal abscess or from a blood-borne infection, e.g., after a drug injection. Synonym: psoas abscessintracranial abscessBrain abscess.intradural abscessAn abscess within the layers of the dura mater. intraperitoneal abscessPeritoneal abscess.ischiorectal abscessAnorectal abscess.kidney abscessAn abscess in the kidney, typically following pyelonephritis or a blood-borne infection. The most common causative organisms are gram-negative bacteria from the lower urinary tract that spread to the kidneys and Staphylococcus aureus from a blood-borne infection. Immunocompromised patients may develop abscesses caused by Nocardia, Candida, or Aspergillus. Occasionally, Mycobacterium tuberculosis and Echinococcus are responsible agents. Synonym: renal abscessTreatmentAntimicrobial agents are used in combination with surgical drainage. Occasionally, nephrectomy or retroperitoneal exploration is required. lacrimal abscessAn abscess in a lacrimal gland or in a lacrimal duct.lateral alveolar abscessAn abscess in periodontal tissue. liver abscess, abscess of the liverAn abscess in the liver caused by pathogenic organisms such as those of species of Bacteroides, Streptococcus, Staphylococcus, or Entamoeba histolytica. SymptomsThe patient will have high fevers; sweats and chills; and an enlarged, painful, tender liver. Pus may be obtained by aspiration. PrognosisEmbolic (multiple) abscesses are generally fatal. Liver abscesses may heal after they have been evacuated and treated with antibiotics. See: hepatic abscesslumbar abscessAn abscess in the lumbar region.lung abscessAn abscess in lung tissue, caused by anaerobic bacteria such as Staphylococcus aureus or Nocardia species. lymphatic abscessAn abscess of a lymph node.mammary abscessAn abscess in the female breast, esp. one involving the glandular tissue. It usually occurs during lactation or weaning. Synonym: breast abscessmastoid abscessAn abscess of the mastoid portion of the temporal bone.metastatic abscessA secondary abscess at a distance from the focus of infection. Synonym: embolic abscess; hypostatic abscess; wandering abscessmiliary abscessesMultiple small embolic abscesses. milk abscessA mammary abscess during lactation. mycotic abscessFungal abscess.nocardial abscessAn abscess caused by Nocardia, e.g., in the lung).orbital abscessAn abscess in the orbit of the eye. palatal abscessAn abscess in a maxillary tooth, erupting toward the palate.palmar abscessAn abscess in the tissues of the palm of the hand. pancreatic abscessAn abscess of pancreatic tissue, usually as a complication of acute pancreatitis or abdominal surgery.parafrenal abscessAn abscess on the side of the frenulum of the penis. parametric abscessAn abscess between the folds of the broad ligaments of the uterus.paranephric abscessAn abscess in the tissues around the kidney. Synonym: perinephric abscessparapancreatic abscessAn abscess in the tissues adjacent to the pancreas. Synonym: peripancreatic abscessparietal abscessA periodontal abscess arising in the periodontal tissue other than the orifice through which the vascular supply enters the dental pulp.parotid abscessAn abscess of the parotid gland.pelvic abscessAn abscess of the pelvic peritoneum, esp. in the pouch of Douglas. It may arise as a complication of a sexually transmitted disease or diverticulitis. perianal abscessAn abscess of the skin around the anus. It usually results from obstruction of intestinal crypts and subsequent fistula formation in the skin. Synonym: periproctic abscessperiapical abscessAn abscess at the apex of a tooth, usually resulting from dental caries or tooth trauma. It may be classified further as an acute periapical abscess, a chronic periapical abscess, a periapical granuloma, or a radicular cyst. Synonym: apical abscess (2); dentoalveolar abscesspericemental abscessAn alveolar abscess not involving the apex of a tooth.pericoronal abscessPericoronitis.peridental abscessAn abscess of periodontal tissue. perinephric abscessParanephric abscess.periodontal abscessAn acute or chronic abscess found in the gingiva, periodontal pockets, or periodontal ligament.peripancreatic abscessParapancreatic abscess.peripleuritic abscessAn abscess in the tissue surrounding the parietal pleura.periproctic abscessPerianal abscess.peritoneal abscessAn abscess within the peritoneal cavity usually following peritonitis. It is usually caused by enteric bacteria, e.g., Escherichia coli, enterococci, or Klebsiella. Synonym: intraperitoneal abscessperitonsillar abscessAn abscess of the tissue around the tonsillar capsule. Needle aspiration of the abscess, with subsequent antibiotic therapy, is an effective treatment in 90% of cases. Synonym: circumtonsillar abscessperiureteral abscessAn abscess in the tissue around a ureter. periurethral abscessAn abscess in tissue surrounding the urethra. perivesical abscessAn abscess in tissue around the urinary bladder. pneumococcic abscessAn abscess due to infection with pneumococci. prelacrimal abscessAn abscess of the lacrimal sac, producing an inflamed, tender swelling at the inner canthus of the eye.premammary abscessA subcutaneous or subareolar abscess of the mammary gland.prostatic abscessAn abscess within the prostate gland. protozoal abscessAn abscess caused by a protozoon. psoas abscessIliopsoas abscess.pulp abscess1. An abscess in the pulp chamber of a tooth.2. An abscess of the tissues of the pulp of a finger.pyemic abscessA metastatic abscess, usually multiple, due to pyogenic organisms.rectal abscessAnorectal abscess.renal abscessKidney abscess.retrocecal abscessAn abscess located behind the cecum. It is an occasional, severe complication of a ruptured appendix or Crohn disease. retromammary abscessAn abscess between the mammary gland and the chest wall.retroperitoneal abscessAn abscess located between the peritoneum and the posterior abdominal wall. It may arise from an abscess in the kidney or from the spread of an intraperitoneal infection posteriorly. retropharyngeal abscessAn abscess of the lymph nodes in the walls of the pharynx. It sometimes simulates diphtheritic pharyngitis. EtiologyStaphylococcus aureus and group A hemolytic streptococcus are the most common pathogens. SymptomsTypically, a history of pharyngitis is elicited. This is followed by high fever, dysphagia, and refusal to eat. The condition progresses to respiratory distress with hyperextension of the head (“sniffing position”), tachypnea, labored breathing, and drooling. An exquisitely tender bulge in the pharyngeal wall is usually evident. TreatmentA retropharyngeal abscess, if fluctuant, should be treated with incision and drainage. If recognized before becoming fluctuant, the abscess should be treated with antibiotics, intravenously administered if the patient is unable to swallow. retrovesical abscessAn abscess behind the bladder.root abscessA colloquial and veterinary term for periapical abscess.runaround abscessA colloquial term for a bacterial infection that surrounds a fingernail; a paronychia.sacrococcygeal abscessAn abscess over the sacrum and coccyx. septicemic abscessAn abscess resulting from septicemia. spermatic abscessAn abscess of the seminiferous tubules. spinal abscessAn abscess due to necrosis of a vertebra. splenic abscessAn abscess of the spleen. It may arise either from the spread of infection from a neighboring organ (that is, a diverticular abscess or a ruptured gastric ulcer) or from hematogenous spread in patients with infective endocarditis. stercoraceous abscessFecal abscessstercoral abscessFecal abscess.sterile abscessAn abscess from which microorganisms cannot be cultivated, an occasional complication of intramuscular injection. stitch abscessAn abscess formed about a stitch or suture. streptococcal abscessAn abscess caused by streptococci. subaponeurotic abscessAn abscess beneath an aponeurosis or fascia. subarachnoid abscessAn abscess of the midlayer of the covering of the brain and spinal cord.subareolar abscessAn abscess underneath the areola of the mammary gland, sometimes draining through the nipple.subdiaphragmatic abscessAn abscess beneath the diaphragm, e.g., an hepatic, splenic, or interperitoneal abscess. Synonym: subphrenic abscesssubdural abscessAn abscess beneath the dura of the brain or spinal cord.subfascial abscessAn abscess beneath the fascia.subgaleal abscessAn abscess beneath the galea aponeuroticai (the epicranial aponeurosis).subpectoral abscessAn abscess beneath the pectoral muscles. subperiosteal abscessA bone abscess below the periosteum. subperitoneal abscessAn abscess between the parietal peritoneum and the abdominal wall.subphrenic abscessSubdiaphragmatic abscess.subscapular abscessAn abscess between the serratus anterior and the posterior thoracic wall.subungual abscessAn abscess beneath the fingernail. It may follow injury from a pin, needle, or splinter. sudoriparous abscessAn abscess of a sweat gland.suprahepatic abscessAn abscess in the suspensory ligament between the liver and the diaphragm.syphilitic abscessAn abscess occurring in the tertiary stage of syphilis, esp. in bone.thecal abscessA spinal epidural abscess.thymus abscessAn abscess of the thymus.tonsillar abscessAcute suppurative tonsillitis.tooth abscessAlveolar abscess.tropical abscessAn amebic abscess of the liver.tuberculous abscessChronic abscess.tubo-ovarian abscessAn abscess involving both the fallopian tube and the ovary. It is typically transmitted sexually. tympanitic abscessEmphysematous abscess.tympanocervical abscessAn abscess arising in the tympanum and extending to the neck.tympanomastoid abscessAn abscess of both the tympanum and the mastoid. urethral abscessAn abscess in the urethra.urinary abscessAn abscess caused by escape of urine into the tissues. urinous abscessAn abscess that contains pus and urine. verminous abscessWorm abscess.wandering abscessMetastatic abscess.warm abscessAcute abscess.worm abscessAn abscess caused by or containing insect larvae, worms, or other animal parasites. Synonym: helminthic abscess; verminous abscessillustrationsubphrenic abscess An abscess under the diaphragm. |