Global Journal of Medical Research, I: Surgeries and Cardiovascular System, Volume 22 Issue 2

µl with a predominant neutrophilic differential count. A chest and abdominal roentgenogram revealed minimal right sided pleural effusion. An Abdomino-pelvic ultrasonography was then performed which revealed a right sided sub-phrenic collection of about 1500 cc pushing liver down with minimal interbowel free fluid, most likely suggestive of infective etiology, right sub- phrenic abscess. Figure 1: Ultrasonography of abdomen showing 1500cc right sub-phrenic collection pushing liver down. The Patient was started on third-generation cephalosporin antibiotics, metronidazole, and amikacin. An Emergency percutaneous draining pigtail catheter of 16 F was inserted in the suprahepatic right subdiaphragmatic space between 11 th and 12 th intercostal space and fixed under ultrasound guidance, and 1100 ml frank pus was drained. Microbiological and biochemical samples for testing were collected and pus sample was sent for culture and antibiotic sensitivity. The residual pus got drained over the later 2 days. A repeat chest and abdominal roentgenogram and abdominopelvic ultrasonography were done on day 3 of percutaneous catheterization, to look for any residual collection. With no radiological or clinical evidence of any sub-phrenic collection, the pigtail catheter was removed after 3 days. The Post-procedure course was uneventful, and patient improved clinically. The patient was later discharged and followed up and managed conservatively thereafter. 16 Year 2022 Global Journal of Medical Research Volume XXII Issue II Version I ( DD ) I © 2022 Global Journals Subdiaphragmatic Abscess: Complication of Emergency Laparotomy