Imaging and Clinical Predictors of Spontaneous Bacterial Peritonitis Diagnosed by Ultrasound-Guided Paracentesis

Sideris, Andrew; Patel, Pooja; Charles, H.; Park, James; Feldman, David; Deipolyi, Amy R.

doi:10.1080/08998280.2017.11929610

Cited by 4 publications

(5 citation statements)

References 13 publications

(15 reference statements)

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“…We found no difference between the 2 groups in the clinical picture: fever, abdominal pain, tenderness in SBP prediction which was like what Sideris et al [15] reported, but against what Makhlouf et al [13] found. This could be due to the low specificity of the abdominal pain value for SBP prediction, as ascites buildup can generate stomach pain on its own.…”

Section: Discussionsupporting

confidence: 74%

“…While Makhlouf et al [13] found abdominal discomfort (89.8.7%), then fever (65.3%) and abdominal tenderness (55.1%) with (30.6%) renal impairment. Sideris et al [15] also found that the most clinical presentation was abdominal pain (75.3%) followed by fever (6.3%).…”

Section: Discussionmentioning

confidence: 90%

“…This could be due to the low specificity of the abdominal pain value for SBP prediction, as ascites buildup can generate stomach pain on its own. Also, fever could be due to other infections in cirrhotic patients [15] . Also, there was no significant difference in hepatic encephalopathy, amount of ascites, or mortality rate between the 2 groups which was like Makhlouf et al [13] result.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of Ascitic Fluid Homocysteine and Calprotectin in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Ahmed

Morsy²,

Yousef³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background and study aim: Spontaneous bacterial peritonitis (SBP) is mainly diagnosed by ascitic polymorphonuclear (PMNL) leukocyte greater than 250/mm 3 . We intended to assess ascitic homocysteine and calprotectin for SBP diagnosis. Materials and methods: In our study, we collected ascitic fluids from 70 patients with liver cirrhosis (46 SBP plus 24 non-SBP according to PMNL>250 cells/mm 3 ). Complete blood count, alanine aminotransferase, aspartate aminotransferase, serum albumin, total bilirubin, prothrombin time, INR, and serum creatinine were measured. Ascitic fluid sample was taken for chemical analysis, homocysteine was calculated in ascites by human homocysteine enzyme-linked immunosorbent assays (ELISA) kits and calprotectin was measured in the ascitic fluids using available human calprotectin enzyme-linked immunosorbent assays (ELISA) kits. Results: SBP patients had considerably greater ascitic homocysteine levels than non-SBP (5.66± 7.15 vs. 2.97±.61 μmol/l) P=0.001. Homocysteine at a cut-off of 3.6 μmol/l had 91.7% specificity, 69.9% sensitivity, PPV 94.1% and NPV 61.1% for SBP diagnosis (area under the curve: 0. 754). SBP patients had considerably greater ascitic calprotectin than the non-SBP (182.98± 76.27 vs. 118.1± 27 ng/mL) P=0.000. Using a cut-off 142 ng/mL, calprotectin had 91.7% specificity, 71.7% sensitivity, PPV 94.2% and NPV 62.9% for SBP diagnosis (area under the curve: 0.768). Conclusion:We found that ascitic homocysteine and calprotectin can be suitable diagnostic markers for SBP diagnosis.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of Ascitic Fluid Homocysteine and Calprotectin in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Ahmed

Morsy²,

Yousef³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…A few studies have shown that paracentesis under cover of intravenous albumin is feasible in patients with spontaneous bacterial peritonitis and tense ascites without any increase in mortality. 17,41,42 Paracentesis is safe in patients with hepatorenal syndrome and tense ascites. In fact, increased intraabdominal pressure may add to renal compromise.…”

Section: Management Of Large Volume or Tense Ascites Treatment Options Available Arementioning

confidence: 99%

HEP-Net opinion on the management of ascites and its complications in the setting of decompensated cirrhosis in the resource constrained environment of Pakistan

et al. 2020

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Approximately one half of patients develop ascites within 10 years of diagnosis of compensated cirrhosis. It is a poor prognostic indicator, with only 50% surviving beyond two years. Mortality worsens significantly to 20% to 50% at one year if the ascites becomes refractory to medical therapy. Pakistan has one of the highest prevalence of viral hepatitis in the world and patients with ascites secondary to liver cirrhosis make a major percentage of both inpatient and outpatient burden. Studies indicate that over 80% of patients admitted with ascites have liver cirrhosis as the cause. This expert opinion suggests proper assessment of patients with ascites in the presence of underlying cirrhosis. This expert opinion includes appropriate diagnosis and management of uncomplicated ascites, refractory ascites and complicated ascites (including spontaneous bacterial peritonitis (SBP) ascites, hepatorenal syndrome (HRS) and hyponatremia. The purpose behind this expert opinion is to help consultants, postgraduate trainees, medical officers and primary care physicians optimally manage their patients with cirrhosis and ascites in a resource constrained setting as is often encountered in a developing country like Pakistan. doi: https://doi.org/10.12669/pjms.36.5.2407 How to cite this:Ali B, Salim A, Alam A, Zuberi BF, Ali Z, Azam Z, et al. HEP-Net opinion on the management of ascites and its complications in the setting of decompensated cirrhosis in the resource constrained environment of Pakistan. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2407 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…62,63 Furthermore, depth of a fluid collection by ultrasound may be an independent risk factor for the presence of spontaneous bacterial peritonitis (SBP), with one small study showing a higher risk of SBP with larger fluid collections than with small ones. 64…”

Section: We Recommend That Ultrasound Guidance Should Be Used To Avoid Attempting Paracentesis In Patients With An Insufficient Volume Ofmentioning

confidence: 99%

Recommendations on the Use of Ultrasound Guidance for Adult Abdominal Paracentesis: A Position Statement of the Society of Hospital Medicine

Cho¹,

Jensen²,

Reierson³

et al. 2019

Journal of Hospital Medicine

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A bdominal paracentesis is a common and increasingly performed procedure in the United States. According to Medicare Physician Supplier Procedure Summary Master Files, an estimated 150,000 paracenteses were performed on Medicare fee-for-service beneficiaries in 2008 alone; such a number represents more than a two-fold increase from the same service population in 1993. 1 This increasing trend was again noted by the Nationwide Inpatient Sample data, which identified a 10% increase in hospitalized patients with a diagnosis of cirrhosis receiving

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Imaging and Clinical Predictors of Spontaneous Bacterial Peritonitis Diagnosed by Ultrasound-Guided Paracentesis

Cited by 4 publications

References 13 publications

Diagnostic Value of Ascitic Fluid Homocysteine and Calprotectin in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

Diagnostic Value of Ascitic Fluid Homocysteine and Calprotectin in Cirrhotic Patients with Spontaneous Bacterial Peritonitis

HEP-Net opinion on the management of ascites and its complications in the setting of decompensated cirrhosis in the resource constrained environment of Pakistan

Recommendations on the Use of Ultrasound Guidance for Adult Abdominal Paracentesis: A Position Statement of the Society of Hospital Medicine

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