Abdominal computed tomography for the diagnosis of intra-abdominal sepsis in critically injured patients: fishing in murky waters.
OBJECTIVE
Abdominal computed tomographic (ACT) scans are useful in the evaluation of sepsis of unknown origin in patients with major trauma.


METHODS
Prospective case series of consecutive patients.


METHODS
Intensive care unit of level I academic trauma center.


METHODS
Eighty-five critically injured patients admitted to the intensive care unit in 32 months (6% of all intensive care unit admissions) who developed sepsis of unknown origin.


METHODS
One hundred sixty-one ACT scans.


METHODS
Sensitivity and specificity of the ACT scans, number of patients subjected to changes in treatment following an ACT scan.


RESULTS
Forty-nine patients (58%) had an intraabdominal focus of infection identified on ACT scan. Penetrating trauma and emergent laparotomy were the only independent factors associated with abnormal findings on ACT scan. The sensitivity and specificity of the test were 97.5% and 61.5%, respectively. Overall, 59 patients (69%) benefited from treatment changes after an ACT scan.


CONCLUSIONS
Abdominal computed tomographic scans reliably identify intra-abdominal foci of infection in patients with major trauma evaluated for sepsis of unknown origin.
Velmahos
G C
GC
Department of Surgery, University of Southern California, Los Angeles, USA. velmahos@hsc.usc.edu
Kamel
E
E
Berne
T V
TV
Yassa
N
N
Ramicone
E
E
Song
Z
Z
Demetriades
D
D
D018784:Abdominal Abscess / Q000000981:diagnostic imaging* / Q000209:etiology; D000328:Adult; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000150:complications*