January 1968

Suprahepatic Abscess

Author Affiliations

USNR, Rochester, NY
From the Department of Surgery, University of Rochester School of Medicine and Dentistry and Strong Memorial Hospital, Rochester.

Arch Surg. 1968;96(1):14-19. doi:10.1001/archsurg.1968.01330190016004

THE first successful surgical attack on a subdiaphragmatic abscess was performed by Von Volkman in 1879.1 The subject then remained in relative obscurity until 1908 when Barnard delivered his treatise on the surgical aspects of subphrenic abscess.2 In it he defined subphrenic abscess as "any localized collection of pus which is in contact with the under surface of the diaphragm."

He depicted the coronary ligaments as suspending the liver from the dome of the diaphragm and dividing the subdiaphragmatic space into six compartments. Until recently all major papers on the subject accepted this anatomical division and defined the subphrenic space as that area from the diaphragm to the transverse mesocolon.

More recently, Boyd,3-5 Moore,6 and Carter and Brewer1 have stressed the fact that the coronary ligaments suspend the liver from the posterior abdominal wall. As have a few others in the past,7-12 they state

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