title: Twelfth rib resection: a direct posterior surgical approach for subphrenic abscesses.
abstract: OBJECTIVE
  To assess the results of twelfth rib resection as a direct posterior surgical approach to subphrenic abscesses in case of failure of percutaneous drainage, abandonment of percutaneous drainage in view of a too high risk of perforation of adjacent organs, or contamination of the pleural space, or an inaccessible abdomen.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University hospital, The Netherlands.
  
  
  METHODS
  17 patients who required rib resection for subphrenic abscesses that developed after infected necrotising pancreatitis, splenectomy, or anastomotic disruption.
  
  
  METHODS
  18 rib resections.
  
  
  METHODS
  Outcome and morbidity.
  
  
  RESULTS
  Twelfth rib resection was successfully in 13 of 17 patients. Four patients died from multiple organ failure despite subsequent (re) laparotomies for additional surgical drainage.
  
  
  CONCLUSIONS
  Twelfth rib resection can be useful for the treatment of subphrenic abscesses in selected patients.
authors.affiliation: Department of Surgery, University Hospital Utrecht, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Bosscha
authors.forename: A J
authors.initials: AJ
authors.lastname: Roukema
authors.forename: T J
authors.initials: TJ
authors.lastname: van Vroonhoven
authors.forename: C
authors.initials: C
authors.lastname: van der Werken
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery*; D013369:Subphrenic Abscess / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods