Appendicitis complicated with Subphrenic Abscess

Right subphrenic collection is noted with cresenctric shape and thick enhancing peripheral wall suggesting relatively walled off subphrenic collection. Appendix region appears  thickened with surrounding periappendiceal stranding and thickening of  anterior renal & lateroconal fascia. Cecal wall appears thickened.These findings possibly suggest appendicitis sequale and loculated subphrenic collection with associated pleural collection.  Pus under a patient's diaphragm has usually spread there from somewhere else in his abdomen. A subphrenic abscess may be secondary to: (1) Peritonitis, either local or general, following a perforated peptic  or a typhoid ulcer , or appendicitis  or PID or infection following Caesarean section (2) An injury which has ruptured a hollow viscus and contaminated his peritoneal cavity  (3) A laparotomy during which his peritoneal cavity was contaminated. (4) A ruptured amoebic liver abscess