May 16, 1931


Author Affiliations

Sullivan, Ind.

JAMA. 1931;96(20):1681-1682. doi:10.1001/jama.1931.27220460002007c

Subdiaphragmatic or subphrenic abscess usually results secondary to infection in the upper abdomen, such as rupture of duodenal or gastric ulcer, hepatic abscess, rupture of empyema through the diaphragm, and occasionally ascending infection from appendical abscess.

In looking through the literature I have failed to find a case of subphrenic abscess due to gonorrheal infection, although Curtis1 has recently described "violin-string or banded adhesions between the liver and the abdominal wall," observed frequently in women with pelvic gonorrheal disease.


History.  —Miss E. R., aged 15, Negress, single, entered the Mary Sherman Hospital, May 28, 1930, at 12:30 a. m. The patient was first seen at her home six hours before. May 24, she had awakened during the night complaining of pain in the upper part of the abdomen. At first this pain was of a cramping character, and she was not nauseated. Menstruation had begun the

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