Radiography Abdomen Although abdominal radiography is portable and rapidly acquired (which is of obvious benefit for a suspected or confirmed septic patient), it rarely provides a definitive diagnosis in the setting of sepsis. It may provide information that increases the probability of an abdominal source such as pneumoperitoneum, but these findings would be either suspected by physical examination or at least partially visualized on chest radiography and would still necessitate further evaluation with CT or US regardless [15,16]. US Abdomen Abdominal/pelvic US is often chosen as an imaging modality in patients of child-bearing age in the evaluation of suspected intraabdominal sepsis. Potential diagnoses responsible for sepsis in this setting can be divided into gynecological causes (such as endometritis, salpingitis, oophoritis, tubo-ovarian abscess, pelvic peritonitis) and nongynecological causes (such as acute appendicitis, diverticulitis, ileitis/colitis, epiploic appendagitis, and urological causes), which can be assessed to varying degrees on US [17]. In the setting of urosepsis, US is often useful as the first imaging modality of choice, in part because of its portability and rapid acquisition, which is of obvious benefit for a suspected or confirmed septic patient [15,16]. Based on recent studies, there is potential value in employment of artificial intelligence techniques to enhance the value of abdominal US in the setting of sepsis, but this discussion is beyond the scope of this topic. Sorenson et al [18] performed a retrospective review of 221 patients with first-time bacteremia suspected to be urosepsis. Of these, 116/221 (52%) of the patients underwent further evaluation with either abdominal US or abdomen/pelvis CT. Major abnormalities were found in 37/115 (32%) of patients and most commonly included pyonephrosis and renal calculi. Of these, 15/115 (13%) of the patients underwent urological intervention as a result of imaging findings.
Sepsis. Radiography Abdomen Although abdominal radiography is portable and rapidly acquired (which is of obvious benefit for a suspected or confirmed septic patient), it rarely provides a definitive diagnosis in the setting of sepsis. It may provide information that increases the probability of an abdominal source such as pneumoperitoneum, but these findings would be either suspected by physical examination or at least partially visualized on chest radiography and would still necessitate further evaluation with CT or US regardless [15,16]. US Abdomen Abdominal/pelvic US is often chosen as an imaging modality in patients of child-bearing age in the evaluation of suspected intraabdominal sepsis. Potential diagnoses responsible for sepsis in this setting can be divided into gynecological causes (such as endometritis, salpingitis, oophoritis, tubo-ovarian abscess, pelvic peritonitis) and nongynecological causes (such as acute appendicitis, diverticulitis, ileitis/colitis, epiploic appendagitis, and urological causes), which can be assessed to varying degrees on US [17]. In the setting of urosepsis, US is often useful as the first imaging modality of choice, in part because of its portability and rapid acquisition, which is of obvious benefit for a suspected or confirmed septic patient [15,16]. Based on recent studies, there is potential value in employment of artificial intelligence techniques to enhance the value of abdominal US in the setting of sepsis, but this discussion is beyond the scope of this topic. Sorenson et al [18] performed a retrospective review of 221 patients with first-time bacteremia suspected to be urosepsis. Of these, 116/221 (52%) of the patients underwent further evaluation with either abdominal US or abdomen/pelvis CT. Major abnormalities were found in 37/115 (32%) of patients and most commonly included pyonephrosis and renal calculi. Of these, 15/115 (13%) of the patients underwent urological intervention as a result of imaging findings.