CT scan image illustrating a percutaneously placed intraabdominal catheter inserted through an intercostal space to drain an infected subphrenic fluid collection that occurred after a distal splenopancreatectomy (Patient #6). This intercostal drain had to be upsized from 12 to 14 French over a wire eight days after initial placement due to a persistent and enlarging subphrenic fluid collection. Subsequently the patient developed a symptomatic left-sided pleural space infection, most likely due to penetration of the diaphragm during upsizing of the drain. The pleural loculations and septations and the signs of systemic infected persisted despite antibiotics and catheter drainage and video-assisted thoracoscopic surgery (VATS) decortication was performed. Bacteria (Pseudomonas aeruginosa) isolated from the subdiaphragmatic collection and complicated pleural effusion were identical and treated accordingly with a 6 week course of antibiotics. The patient recovered quickly and was doing well in a three months clinical follow-up.