Muhammad Akram, Mohammad Humayun, Abad-ur-rehman Awan, Iftikhar Ahmed Naru, Abdul Fateh Qureshi.
Prevalence of Spontaneous Bacterial Peritonitis in Cirrhotic Patients with Ascites.
Pak J Med Health Sci Jan ;6(4):1074-7.

Objective: To find out the prevalence of spontaneous bacterial peritonitis in cirrhotic patients. Subjects and methods: This prospective study was conducted at Department of Medicine Liaquat University Hospital, Hyderabad between 1st January 2005 to 30th June 2005. This study included 50 known patients of cirrhosis of liver with ascites and with a clinical suspicion of spontaneous bacterial peritonitis admitted to medical wards of Liaquat University Teaching Hospital, Hyderabad. Diagnosis of spontaneous bacterial peritonitis was based on an ascitic fluid neutrophilic count of >250/mm3 and/or a positive culture without evidence of secondary peritonitis and chronic liver disease were included in the study. Patients with non-cirrhotic ascites, evidence of secondary peritonitis, haemorrhagic ascites and evidence of intra-abdominal malignancy were excluded from the study. A detailed history and physical examination of all the patients were taken with special reference to the signs and symptoms of hepatocellular insuffiency and portal hypertension. 10 ml of ascitic fluid was withdraw and sent for examination. Abdominal ultrasonography was done in every patient to find out liver size, surface and texture, splenic enlargement and portal vein diameter. Results: Out of 50 cirrhotic patients the viral markers study revealed that HBsAg positive 20, anti-HCV positive 28 and both HBsAg and anti-HCV positives in 2. Final outcome of patients of spontaneous bacterial peritonitis with encephalopathy, 11 patients were died and 6 were discharged and without encephalopathy 4 died and 8 were discharged. Conclusion: We conclude that SBP is a frequent complication, depends of the severity of liver failure and is a marker for poor prognosis in patients with liver cirrhosis.

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