Spontaneous bacterial peritonitis: risk factors and relationship to serum-ascites albumin gradient in chronic liver disease patient

  • Dr Rakesh Kumar Professor of Medicine, B.R.D Medical College,Gorakhpur, UP, India
  • Dr Mridul Bhushan Associate Professor of Medicine, Government Medical college, Kannouj, UP, India
  • Dr P Nigam Ret. Professor and Head, Department of Medicine, B.R.D Medical College, Gorakhpur, UP, India
Keywords: Spontaneous Bacterial Peritonitis, SAAG, Serum cirrhotic ascites

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is probably the best characterized infectious complication that develops in patients with cirrhosis and ascites.

Aims and objective: The present study was done to find the incidence of SBP in patients of chronic liver disease and to find its correlation with serum ascites albumin gradient.

Material and Methods: A total of 55 patients were selected for the study and divided into 2 groups; Group A - spontaneous bacterial peritonitis (SBP) and Group B -sterile cirrhotic ascites (SCA). Diagnosis was done by calculating SAAG (Serum Ascites Albumin Gradient) which reflects the differences in osmotic pressure and correlates with portal venous pressure. Total ascitic protein and ascitic -serum total protein ratio were taken as a diagnostic parameter for SBP.

Results: Maximum incidence of disease was found between 31-50 years of age. Serum albumin values in SBP (2.50±0.31 gm/dl) when compared with SCA (2.85±0.39) and total ascites albumin in SBP (0.41±0.21) with SCA (0.89±0.31) were significantly different (p<0.001, t=3.59 and p<0.001, t=6.58 respectively). No significant difference (p>0.05, t=1.17) was found in serum ascites albumin gradient (SAAG), when it was compared between SBP (2.09±0.42 mg/dl) and SCA (1.96±0.37 gm/dl).

Conclusion: In a patient of cirrhosis with ascites early diagnosis of development of SBP in a case of SCA can prevent mortality.

Downloads

Download data is not yet available.

References

Hoefs JC, Hanna NC, Francisco L, Hopkins RR, Weines J, Montgomerie JZ. Spontaneous bacterial peritonitis. Hepatology 1982; 2(4): 399-407.doi: https://doi.org/10.1002/hep.1840020402.

Ljubicic N, Bilic A, Babic Z, Roic D, Banic M. The Significance of low levels of total proteins , albumins, globulins and complement factors in ascetic fluid and the development of spontaneous bacterial peritonitis in patients with liver cirrhosis. Lijec Vjesn 1992; 114(9-12):213-5.

Wilcox D, William E. Spontaneous bacterial peritonitis: A review of Pathogenesis, diagnosis and treatment. Medicine 1987; 66 (6): 447-56.

Henry RJ, Cannon DC, Winkelman JW. Clinical chemistry, principles and techniques, 2nd ed. Harper & Row, Newyork.1974.

Doumas BT, Watson WA, Biggs HG. Albumin standards and the measurement of serum albumin with bromocresol green. Clin Chim Acta 1971; 31(1):87-96.doi: https://doi.org/10.1016/0009-8981(71)90365-2.

Albillos A, Cuervas MV, Millan I, Conton T, Mentes J, Barrious C et al. Ascitic Fluid Polymorphonuclear cell count and serum to ascetic albumin gradient in the diagnosis of bacterial peritonitis. Gastroenterology. 1990; 98(1):134-40.

Pare P, Talbort J, Hoefs JC. Serum ascetic albumin gradient-A physiological approach to the different diagnosis of ascites. Gastroenterology. 1983; 85(2):240-4.

Runyon BA, Hoefs JC. Ascitic fluid analysis in the differenciation of spontaneous bacterial peritonitis from gastrointestinal tract perforation into ascetic fluid. Hepatology 1984; 4(3):447-80.doi: https://doi.org/10.1002/hep.1840040316.

Spontaneous bacterial peritonitis: risk factors and relationship to serum-ascites albumin gradient in chronic liver disease patient
CITATION
DOI: 10.17511/ijmrr.2016.i09.31
Published: 2016-09-30
How to Cite
1.
Kumar R, Bhushan M, Nigam P. Spontaneous bacterial peritonitis: risk factors and relationship to serum-ascites albumin gradient in chronic liver disease patient. Int J Med Res Rev [Internet]. 2016Sep.30 [cited 2024Apr.27];4(9):1702-5. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/702
Section
Original Article