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Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis
06:45

Colon Ascendens Stent Peritonitis (CASP) - a Standardized Model for Polymicrobial Abdominal Sepsis

Published on: December 18, 2010

Diagnosis, treatment and prevention of spontaneous bacterial peritonitis

J Fernández1, T M Bauer, M Navasa

  • 1Liver Unit, University of Barcelona, Spain.

Bailliere'S Best Practice & Research. Clinical Gastroenterology
|January 5, 2001
PubMed

Insights

Spontaneous bacterial peritonitis (SBP) is a common infection in cirrhotic patients. Early diagnosis and effective antibiotics improve outcomes, but serious complications and mortality remain concerns, highlighting the need for transplantation evaluation.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Spontaneous bacterial peritonitis (SBP) is a frequent complication in patients with liver cirrhosis and ascites.
  • Diagnosis relies on ascitic fluid polymorphonuclear cell count ≥250 cells/mm³.
  • Culture-negative SBP occurs in 30-40% of cases but is treated similarly to culture-positive SBP.

Purpose of the Study:

  • To review the diagnosis, treatment, and outcomes of spontaneous bacterial peritonitis in cirrhotic patients.
  • To highlight factors influencing SBP prognosis and associated complications.

Main Methods:

  • Review of diagnostic criteria for SBP.
  • Analysis of treatment strategies and their impact on resolution rates.
  • Evaluation of SBP-related complications and mortality.

Main Results:

  • SBP resolution rates range from 70-90%, with hospital survival between 50-70%.
  • Improvements in prognosis are attributed to early diagnosis and optimized antibiotic therapy.
  • Despite treatment, SBP can lead to renal impairment, gastrointestinal bleeding, and hepatic insufficiency.

Conclusions:

  • Early diagnosis and appropriate antibiotic therapy are crucial for improving SBP outcomes.
  • SBP management requires vigilance for severe complications that contribute to mortality.
  • Liver transplantation should be considered for patients recovering from SBP episodes.

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