FREQUENCY OF ASYMPTOMATIC SPONTANEOUS BACTERIAL PERITONITIS IN OUTDOOR PATIENTS WITH LIVER CIRRHOSIS

Spontaneous Bacterial Peritonitis in Cirrhosis

Abstract

Objective: The objective of this study was to the incidence of silent SBP in asymptomatic cirrhotic patients of Military Hospital out patient department.

Study Design: Prospective study.

Place and Duration of Study: Gastroenterology Department, Military Hospital Rawalpindi from July 2013 to Dec 2013.

Material and Methods: Prospective exploration for evidence of SBP in asymptomatic cirrhotic patients due to any etiology with ascites. Clinical and laboratory features of consecutive outpatients with cirrhotic ascites undergoing paracentesis were recorded between July 2013 and December 2013 and ascitic fluid analysis was carried out.

Results: The frequency of spontaneous bacterial peritonitis in the population of 80 cirrhotic outpatients as determined by neutrocytic ascites (absolute neutrophil count >250 cells/mm) was 10%. Of the 8 patients with neutrocytic ascites, none was culture positive. The patients with absolute neutrophil count > 250 cells/mm were treated with antibiotics for seven days. Repeat diagnostic paracentesis showed marked improvement in absolute neutrophilic count. None of the patients developed hepatorenal syndrome or hepatic encephalopathy or recurrent SBP during 3 months follow up.

Conclusion: Incidence of silent SBP in asymptomatic cirrhotic patients’ cases is significantly high. Antibiotic treatment in these patients ensures no further complications. However, a larger population may be studied to know the exact prevalence of silent SBP in our country.