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Subphrenic Abscess

Infectious Diseases · NLM MeSH · updated 2026-10-29 · version 1

Citations verified against PubMedNot yet clinician-reviewed8 referencesApproximately 2 min read

Accumulation of purulent exudates beneath the diaphragm, also known as upper abdominal abscess.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 2 complete abstracts (408 words), 8 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

Accumulation of purulent exudates beneath the diaphragm, also known as upper abdominal abscess. It is usually associated with peritonitis or postoperative infections.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Abscesses, Subphrenic; Subphrenic Abscesses; Abscess, Subdiaphragmatic; Abscesses, Subdiaphragmatic; Subdiaphragmatic Abscesses; Abscess, Subphrenic; Subdiaphragmatic Abscess.

Where it fits in the MeSH classification

Broader topics
Peritonitis; Abdominal Abscess

Related concepts

  • Exudates
  • Diaphragm
  • Peritonitis

Research landscape

PubMed indexes 1,087 records tagged with the MeSH heading “Subphrenic Abscess” (counts retrieved 2026-10-29). 5 of them (0.5%) were published from 2020 onward, and the busiest period so far is through 1999 with 965 records.

Reviews account for 52 records (4.8%) and meta-analyses for 0. Randomized controlled trials number 1 (0.1%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 965 records; 2000-2009: 72 records; 2010-2019: 45 records; 2020 onward: 5 records965through 1999722000-2009452010-201952020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 1999965
2000-200972
2010-201945
2020 onward5
Share of records by publication typeReviews: 4.8 percent; Meta-analyses: 0.0 percent; Randomized controlled trials: 0.1 percentReviews4.8% (52)Meta-analyses0.0% (0)Randomized controlled trials0.1% (1)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 1,087 PubMed records
TypeRecordsShare
Reviews524.8%
Meta-analyses00.0%
Randomized controlled trials10.1%

Method: PubMed query "Subphrenic Abscess"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.

Reading the evidence in infectious diseases

Infectious disease evidence combines microbiology, epidemiology and clinical trials. Laboratory studies identify pathogens and how they cause harm; surveillance and outbreak investigations describe who is affected and how infection spreads; trials establish whether treatments and vaccines work. Results depend on place and time, because pathogens evolve and resistance patterns and population immunity change. Check when and where the data were collected, how cases were defined and how up to date the evidence is.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Endoscopic ultrasound-guided transmural drainage for subphrenic abscess: report of two cases and a literature review
Morita S, Kamimura K, Suda T, Oda C, Hoshi T, Kanefuji T, et al.
2018Review article
Design not recorded in structured metadata
10cc by
PMID 29699494 · DOI · PMC5921389
Subdiaphragmatic abscess due to penetration of a duodenal ulcer successfully treated with endoscopic transgastric drainage: a case report
Takami T, Takihara H, Yasuda K, Kasyu N, Yoshitake H, Shintani H, et al.
2021Research article
Design not recorded in structured metadata
2cc by
PMID 34304731 · DOI · PMC8311959

Endoscopic ultrasound-guided transmural drainage for subphrenic abscess: report of two cases and a literature review [1]

Review article Morita S, Kamimura K, Suda T, Oda C, Hoshi T, Kanefuji T, et al. · · 2018 · cited 10 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundAn intra-abdominal abscess can sometimes become serious and difficult to treat.
Closing excerpt
As there have been no comparative studies to date, a prospective study involving a large number of patients will be necessary to determine the therapeutic options for such cases.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (229 words)

BackgroundAn intra-abdominal abscess can sometimes become serious and difficult to treat. The current standard treatment strategy for intra-abdominal abscess is percutaneous imaging-guided drainage. However, in cases of subphrenic abscess, it is important to avoid passing the drainage route through the thoracic cavity, as this can lead to respiratory complications. The spread of intervention techniques involving endoscopic ultrasonography (EUS) has made it possible to perform drainage via the transmural route.Case presentationWe describe two cases of subphrenic abscess that occurred after intra-abdominal surgery. Both were treated successfully by EUS-guided transmural drainage (EUS-TD) without severe complications. Our experience of these cases and a review of the literature suggest that the drainage catheters should be placed both internally and externally together into the abscess cavity. In previous cases there were no adverse events except for one case of mediastinitis and pneumothorax resulting from transesophageal drainage. Therefore, we consider that the transesophageal route should be avoided if possible.ConclusionsAlthough further studies are necessary, our present two cases and a literature review suggest that EUS-TD is feasible and effective for subphrenic abscess, and not inferior to other treatments. We anticipate that this report will be of help to physicians when considering the drainage procedure for this condition. As there have been no comparative studies to date, a prospective study involving a large number of patients will be necessary to determine the therapeutic options for such cases.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29699494 · DOI · PMC5921389

Subdiaphragmatic abscess due to penetration of a duodenal ulcer successfully treated with endoscopic transgastric drainage: a case report [2]

Research article Takami T, Takihara H, Yasuda K, Kasyu N, Yoshitake H, Shintani H, et al. · · 2021 · cited 2 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundSubdiaphragmatic abscesses are sometimes caused by intraabdominal infections.
Closing excerpt
We suggest that our success with endoscopic ultrasound-guided transgastric drainage in this patient indicates that this approach can be considered in similar cases and that it can be selected as a minimally invasive treatment method.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (179 words)

BackgroundSubdiaphragmatic abscesses are sometimes caused by intraabdominal infections. We report a case of endoscopic ultrasound-guided transgastric drainage.Case presentationA 75-year-old Asian man was referred to our hospital for treatment for upper gastrointestinal bleeding. On admission, blood tests showed a marked inflammatory response, and abdominal computed tomography showed free air in the abdominal cavity and a left subdiaphragmatic abscess. Therefore, the patient was diagnosed with an intraabdominal abscess associated with a perforated duodenal ulcer. Because he did not have generalized peritonitis, fasting and antibiotic treatment were the first therapies. However, because of the strong pressure on the stomach associated with the abscess and difficulty eating, we performed endoscopic ultrasound-guided transgastric drainage. After treatment, the inflammatory response resolved, and food intake was possible. The patient's condition remains stable.ConclusionsDrainage is the basic treatment for subdiaphragmatic abscesses; however, percutaneous drainage is often anatomically difficult, and surgical drainage is common. We suggest that our success with endoscopic ultrasound-guided transgastric drainage in this patient indicates that this approach can be considered in similar cases and that it can be selected as a minimally invasive treatment method.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 34304731 · DOI · PMC8311959

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article The subphrenic spaces and the emperor's new robes [3]
    Boyd DP · N Engl J Med · 1966 · cited 15 times (Europe PMC)
  • Research article The changing epidemiology of subphrenic abscess and its clinical and radiological consequences [4]
    Sanders RC · Br J Surg · 1970 · cited 7 times (Europe PMC)
  • Research article Classification, diagnosis and treatment of subphrenic abscesses [5]
    Ariel IM, Kazarian KK · Rev Surg · 1971 · cited 5 times (Europe PMC)
  • Research article Delayed recurrence of postoperative intra-abdominal abscess: an unusual case and review of the literature [6]
    Tomita H, Osada S, Miya K, Matsuo M · Surg Infect (Larchmt) · 2006 · cited 3 times (Europe PMC)
  • Research article Subphrenic abscess [7]
    Konvolinka CW, Olearczyk A · Curr Probl Surg · 1972 · cited 3 times (Europe PMC)
  • Research article Rdiological and radioisotopic diagnosis of perihepatic abscess [8]
    Sanders RC · CRC Crit Rev Clin Radiol Nucl Med · 1974 · cited 2 times (Europe PMC)

References

  1. Morita S, Kamimura K, Suda T, Oda C, Hoshi T, Kanefuji T, et al.. Endoscopic ultrasound-guided transmural drainage for subphrenic abscess: report of two cases and a literature review. . 2018. PMID 29699494 · DOI · PMC5921389
  2. Takami T, Takihara H, Yasuda K, Kasyu N, Yoshitake H, Shintani H, et al.. Subdiaphragmatic abscess due to penetration of a duodenal ulcer successfully treated with endoscopic transgastric drainage: a case report. . 2021. PMID 34304731 · DOI · PMC8311959
  3. Boyd DP. The subphrenic spaces and the emperor's new robes. N Engl J Med. 1966. PMID 5331126 · DOI
  4. Sanders RC. The changing epidemiology of subphrenic abscess and its clinical and radiological consequences. Br J Surg. 1970. PMID 4914497 · DOI
  5. Ariel IM, Kazarian KK. Classification, diagnosis and treatment of subphrenic abscesses. Rev Surg. 1971. PMID 4925864
  6. Tomita H, Osada S, Miya K, Matsuo M. Delayed recurrence of postoperative intra-abdominal abscess: an unusual case and review of the literature. Surg Infect (Larchmt). 2006. PMID 17233573 · DOI
  7. Konvolinka CW, Olearczyk A. Subphrenic abscess. Curr Probl Surg. 1972. PMID 4550910
  8. Sanders RC. Rdiological and radioisotopic diagnosis of perihepatic abscess. CRC Crit Rev Clin Radiol Nucl Med. 1974. PMID 4595857

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-29.

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Related research topics

  • PeritonitisInfectious Diseases
  • Brain AbscessInfectious Diseases
  • Epidural AbscessInfectious Diseases
  • Gingival Crevicular FluidAnatomy and Physiology
  • PerineumAnatomy and Physiology
  • DiaphragmAnatomy and Physiology

All 102 articles in Infectious Diseases →

At a glance

1,087
PubMed records on this heading
0%
published since 2020
52
review articles
1
randomized trials
8
verified references below

Counts come from PubMed on 2026-10-29; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • PeritonitisInfectious Diseases
  • Brain AbscessInfectious Diseases
  • Epidural AbscessInfectious Diseases
  • Gingival Crevicular FluidAnatomy and Physiology
  • PerineumAnatomy and Physiology

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