This space is separated into 4 intraperitoneal and 2 extraperitoneal spaces. The falciform ligament divides the space into right and left, and each side is further divided into anterior and posterior spaces by the lateral ligaments. The left extraperitoneal space is just above the pole of the kidney, and the right extraperitoneal space is between the layers of the coronary ligaments.
Patients present with fever, abdominal pain, cough, and dyspnea. If diagnosis and treatment is expedited, many patients will achieve full recovery. If left untreated or if severe sepsis or respiratory failure develops, subdiaphragmatic abscesses can be potentially fatal.
K65.1 – Peritoneal abscess
52478002 – Subdiaphragmatic abscess
Differential Diagnosis & Pitfalls
- Pleural effusion
- Other abscesses (eg, liver [amebic, pyogenic], spleen, pancreas)
- Diaphragmatic perforation
- Diaphragmatic hernia
- Malignancy (particularly pancreaticobiliary, gastrointestinal, lymphoma, or metastatic lesions)
- Splenic infarction
- Inflammatory bowel disease (Crohn disease or ulcerative colitis)
- Pancreatic pseudocyst
- Hollow viscus perforation
- Bowel obstruction (large, small)
- Mesenteric ischemia