EPSS: One name, Two meanings.

You might have heard of EPSS, or E Point Septal Separation, in echocardiography. What about EPSS in abdominal sonography ?

A middle age man presented to our A&E with 2 days of abdominal pain. Clinically, it was an acute abdomen, with guarding and rigidity.

What could be the cause?

A bedside FAST shows this:

Free fluid is seen in the right paracolic gutter (blue arrow), not in the morrison’s pouch. Not good news for the patient.

A close up of the ventral aspect of the liver using a high frequency linear probe showed this:

Did you see the EPSS which explains the patient’s clinical findings?


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