We report a case of a 34-year-old male who presented with a productive cough, fever, weakness, reduced appetite, and sleep for 15 days. On examination, a soft palpable lump was identied in the epigastric region, and a large thick-walled lesion was noted in the left para-cardiac region extending caudal to the heart. The patient was diagnosed with subdiaphragmatic abscess, which was suspected to be arising due to chronic liver disease and a history of recurrent ascites and multiple tapping. The causative organism was identied as E. coli, and the patient underwent on ct scan a diagnostic laparoscopy followed by exploration with subdiaphragmatic abscess drainage. The pus samples were sent for histopathological evaluation, which conrmed the presence of occasional pus cells and gram-negative bacilli. The patient was discharged and advised to follow up with regular check-ups.

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