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Updated: Aug 10, 2026
06:02
Posterior Approach for Debridement of the Psoas Abscess
Published on: March 2, 2020
[A case of empyema with subphrenic abscess]
Summary
Empyema can present with abdominal pain, especially in immunocompromised patients. Prompt abdominal imaging is crucial for diagnosing subphrenic abscesses, a complication of empyema.
Area of Science:
- Infectious Diseases
- Pulmonology
- Abdominal Surgery
Background:
- A 75-year-old female with a history of cholecystectomy presented with fever, cough, and left hypochondralgia.
- Initial chest X-ray revealed bilateral pleural effusion, leading to tube drainage for empyema.
Observation:
- Empyema was diagnosed, caused by Bacteroides fragilis and Escherichia coli (E. coli).
- Despite antibiotic treatment, left hypochondralgia persisted, suggesting a complication.
Findings:
- Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) identified a subphrenic abscess near the spleen, also caused by E. coli.
- Ultrasound-guided drainage of the subphrenic abscess led to rapid symptom resolution.
Implications:
- This case highlights the necessity of abdominal examination in empyema patients, particularly those who are immunocompromised.
- Prior abdominal surgery and biliary tract issues should be considered in the diagnostic workup of complicated empyema.
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