There is levocardia but with situs anomaly of the subphrenic
organs including central, left-dominant liver, and right-sided stomach and spleen (with polysplenia).
1) Uncommon complications described in the literature include subphrenic
abscess, small-bowel perforation with secondary formation of a cerebrospinal-enteric fistula, untreatable CSF ascites, migration of the shunt tip to distant locations such as the intrathoracic or subphrenic
areas, protrusion of the shunt from the anus and pseudocyst formation.
An erect chest x-ray showed an area of increased opacification in the right lower zone, with gas in the right subphrenic
space which was reported to be Chilaiditi's syndrome.
Eight patients (20%) developed a procedure-related complication that included cholangitis after stent insertion (N=3), cholangitic liver abscess (N=1), subphrenic
liver collection (N=1), bile leakage (N=1) and cholecystitis (N=2).
A CT scan performed at the 6-month follow-up revealed recurrent soft tissue masses in the postoperative tumor bed and in other sites within the abdomen (the left subphrenic
region, the lesser sac, the left renal fossa, and the perisplenic region) (Figure 3).
Radiological case of the month: Mahender K. Narula, MBBS, MD, Rachna Madan, MBBS, MD,DNB, Om Prakash Pathania, MBBS, MS, and Rama Anand, MBBS, MD
The erect chest radiograph demonstrated ectasia of the thoracic aorta but no subphrenic
1a) and no free subphrenic
air on the chest radiograph (Fig.
19) Extrahepatic abscesses tend to occur in the subphrenic
or subhepatic spaces, and percutaneous drainage is normally feasible.
Percutaneous drainages of intra-abdominal collections are routinely undertaken, commonly in the subphrenic area.
One such area is the high right subphrenic space, as in this patient with a collection seen on CT and ultrasound (Figs 1 and 2), thought to be on the basis of a ruptured liver abscess.
Percutaneous drainage of subphrenic abscess: a review of 62 patients.
Bending of needles is contra-indicated and special curved needles need to be used for difficult subphrenic