title: Abdominal computed tomography for the diagnosis of intra-abdominal sepsis in critically injured patients: fishing in murky waters.
abstract: 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.
authors.affiliation: Department of Surgery, University of Southern California, Los Angeles, USA. velmahos@hsc.usc.edu
authors.forename: G C
authors.initials: GC
authors.lastname: Velmahos
authors.forename: E
authors.initials: E
authors.lastname: Kamel
authors.forename: T V
authors.initials: TV
authors.lastname: Berne
authors.forename: N
authors.initials: N
authors.lastname: Yassa
authors.forename: E
authors.initials: E
authors.lastname: Ramicone
authors.forename: Z
authors.initials: Z
authors.lastname: Song
authors.forename: D
authors.initials: D
authors.lastname: Demetriades
mesh_terms: 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*