Halvorsen R A, Jones M A, Rice R P, Thompson W M
AJR Am J Roentgenol. 1982 Aug;139(2):283-9. doi: 10.2214/ajr.139.2.283.
Abdominal abscesses located in the left upper quadrant may occur in two major anatomic locations, the subphrenic space or the lesser sac. The left coronary or triangular ligament extending from the dorsal aspect of the liver to the diaphragm separates the subphrenic space from the lesser sac. As the ligament usually extends posteriorly, the anterior subphrenic space extends under the dome of the diaphragm, occupying the most superior part of the left upper quadrant. Both the lesser sac and the left anterior subphrenic space extend to the right of midline. The left anterior subphrenic compartment is bounded on the right by the falciform ligament while the lesser sac extends to the right coronary ligament and foramen of Winslow. Therefore, abscesses either in the left anterior subphrenic compartment or lesser sac may extend across the midline into the right upper quadrant. Left anterior subphrenic abscesses will be immediately subdiaphragmatic while lesser sac abscesses extending to the right of midline will not usually extend up to the diaphragm. Six cases are presented demonstrating midline air-fluid levels and soft-tissue masses in the immediate subdiaphragmatic area, characteristic signs of anterior left subphrenic abscesses.
位于左上腹的腹部脓肿可能发生在两个主要解剖部位，即膈下间隙或网膜囊。从肝脏背侧延伸至膈肌的左冠状韧带或三角韧带将膈下间隙与网膜囊分隔开。由于该韧带通常向后延伸，膈下前间隙在膈肌穹窿下方延伸，占据左上腹的最上部。网膜囊和左膈下前间隙均延伸至中线右侧。左膈下前间隙右侧以镰状韧带为界，而网膜囊延伸至右冠状韧带和网膜孔。因此，左膈下前间隙或网膜囊内的脓肿可能会越过中线延伸至右上腹。左膈下前脓肿紧邻膈下，而延伸至中线右侧的网膜囊脓肿通常不会向上延伸至膈肌。本文介绍了6例病例，显示了紧邻膈下区域的中线气液平面和软组织肿块，这是左膈下前脓肿的特征性表现。
