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Post-sclerotherapy bacterial peritonitis
1Division of Gastroenterology, Salt Lake City VA Medical Center, Utah.
Abstract:
Endoscopic variceal sclerotherapy has been associated with a number of complications. Peritonitis after sclerotherapy has rarely been reported. In this retrospective review of 213 consecutive sclerotherapy procedures among 65 patients over a 3-yr period, we found that six cases of peritonitis occurred, for an incidence of approximately 3%. All patients developing post-sclerotherapy peritonitis had low ascitic fluid protein. However, this did not differ from patients who did not develop peritonitis. No patient on antibiotics at the time of sclerotherapy developed peritonitis. Peritonitis should be considered in the diagnosis of post-sclerotherapy fever. The role of prophylactic antibiotics to prevent this complication is uncertain.
Insights
Peritonitis is a rare complication of endoscopic variceal sclerotherapy, occurring in about 3% of procedures. Prophylactic antibiotics may prevent peritonitis, but further research is needed.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Infectious complications
Background:
- Endoscopic variceal sclerotherapy is a common treatment for esophageal varices.
- Complications can arise from sclerotherapy, though peritonitis is rare.
Observation:
- A retrospective review analyzed 213 sclerotherapy procedures in 65 patients over 3 years.
- Six cases of peritonitis were identified, an incidence of approximately 3%.
Findings:
- Patients who developed peritonitis had low ascitic fluid protein, similar to those without peritonitis.
- No patients receiving antibiotics during sclerotherapy developed peritonitis.
Implications:
- Peritonitis should be considered in patients with fever after sclerotherapy.
- The efficacy of prophylactic antibiotics in preventing post-sclerotherapy peritonitis requires further investigation.