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

Published on: December 18, 2010

Spontaneous bacterial peritonitis.

Anastasios Koulaouzidis1, Shivaram Bhat, Athar A Saeed

  • 1Endoscopy Unit, Centre of Liver & Digestive Disorders, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, Scotland, EH16 4SA, United Kingdom. akoulaouzidis@hotmail.com

World Journal of Gastroenterology
|March 7, 2009
PubMed
Summary
This summary is machine-generated.

Spontaneous bacterial peritonitis (SBP) is now treatable, but still prevalent and recurrent in cirrhosis patients. Management includes antibiotics, albumin, and considering liver transplantation for improved outcomes.

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Characterizing Salmonella Typhimurium-induced Septic Peritonitis in Mice
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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Spontaneous bacterial peritonitis (SBP) was historically fatal (90% mortality) but is now a treatable complication of decompensated cirrhosis.
  • Despite advances, SBP remains prevalent with a high rate of recurrence, driven by bacterial translocation and impaired host defenses in cirrhosis.
  • Effective management strategies have transformed SBP from a feared disease to a manageable condition.

Purpose of the Study:

  • To review the current understanding and management of spontaneous bacterial peritonitis (SBP) in patients with decompensated cirrhosis.
  • To highlight key diagnostic and therapeutic advancements, including antibiotic choices and supportive care.
  • To emphasize the importance of long-term prophylaxis and liver transplantation considerations.

Main Methods:

  • Literature review of SBP pathogenesis, diagnosis, treatment, and prevention strategies.
  • Analysis of diagnostic tools such as leucocyte esterase reagent strips and ascitic fluid pH.
  • Evaluation of therapeutic interventions including antibiotics (third-generation cephalosporins) and albumin.

Main Results:

  • Third-generation cephalosporins are the recommended antibiotics for SBP treatment.
  • Leucocyte esterase reagent strips can expedite diagnosis, and future research may combine them with ascitic fluid pH measurement.
  • Renal dysfunction is a significant predictor of mortality in SBP patients.

Conclusions:

  • SBP is a treatable complication of cirrhosis, requiring prompt diagnosis and appropriate management.
  • Albumin administration may mitigate renal impairment by enhancing intravascular volume and binding inflammatory molecules.
  • Long-term antibiotic prophylaxis and consideration for liver transplantation are crucial after an SBP episode to prevent recurrence and improve survival.