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August 1937


Author Affiliations

Clinical Associate Professor of Surgery, Rush Medical College of the University of Chicago CHICAGO

Arch Surg. 1937;35(2):241-257. doi:10.1001/archsurg.1937.01190140033003

A subphrenic abscess may be defined as one which at some point is in contact with the under-surface of the diaphragm. Barlow described the condition in 1845, while Volkmann recorded the first operation in 1879.

It is my purpose to emphasize the importance of early diagnosis and operation, to report my cases and also an original, safer, transcostal, extrapleural method of drainage and to point out the necessity for choosing the most suitable operative route, depending on the location and the size of the abscess.

The subphrenic area is considered to be that space bounded above by the diaphragm and below by the transverse mesocolon. This space may be divided for clinical purposes into a suprahepatic and an infrahepatic space, and these may be divided into lesser but less completely separated spaces. A subphrenic abscess may occupy all or only a part of one or more adjoining spaces, depending on

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