Subhepatic Intraperitoneal Abscess

INTRAPERITONEAL abscess is rare in patients without preceding abdominal surgery or trauma. Only about 15% of all subphrenic abscesses develop without these predisposing factors; most are due to a perforated viscus or cholecystitis.^1-3 Because the therapy includes both appropriate antibiotics and surgical drainage, early identification and accurate localization of an abscess are essential for management. Clinical suspicion of an abdominal abscess in a patient who does not have a history of surgery or trauma is usually low. An unusual case of an intravenous drug abuser with a large subhepatic abscess is described to highlight the pertinent clinical and roentgenographic findings.

Report of a Case  A 27-year-old man with a long history of heroin and alcohol abuse came to the emergency room at night with a history of three weeks of increasing right upper quadrant and right lower chest pain, worse on deep inspiration. He also complained of daily fever,