Subphrenic Suppuration and its Complications.

THE diagnosis of subphrenic abscesses can be notoriously difficult. This fact is well expressed by the well known aphorism: 'Pus somewhere, pus nowhere else, pus under the diaphragm'. Even more puzzling can be the features when complications, which occur relatively f.requently, dominate the clinical picture. The situation of the subphrenic spaces, hidden under the rigid concavity of the ribs and therefore inaccessible to palpation, is mainly responsible for the paucity of obvious clinical signs. The purpose of this article is to stress the not so infrequent bizarre presentation of subphrenic suppuration and draw the clinician's attention to this hidden area.