For the purposes of this paper, owing to the similarity in the clinical manifestations of subphrenic and nonamebic liver abscess, these two conditions are considered together, an additional reason being that they are often associated in the same patient and their surgical management is identical.
Any localized collection of pus in contact with the undersurface of the diaphragm is considered by Barnard1 as a subphrenic abscess. He also included any liver abscess which is near the surface and more or less intimately associated with the diaphragm. This designation appears proper in view of the similarity of the clinical features as presented in the cases of both liver and subphrenic abscess. This similarity is so great in many of the cases as to make a differential diagnosis either difficult or impossible.
A suppurative process in the subphrenic space and liver occurs under a variety of circumstances. Infection usually reaches the
SCHWARTZ J. SUPPURATION IN THE SUBPHRENIC REGIONWITH SPECIAL REFERENCE TO PRIMARY IDIOPATHIC LIVER AND SUBPHRENIC ABSCESS. Arch Surg. 1930;20(2):317–332. doi:10.1001/archsurg.1930.01150080145008