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Does spontaneous bacterial peritonitis occur in malignant ascites?
The American Journal of Gastroenterology
|March 1, 1982
Summary
Spontaneous bacterial peritonitis (SBP) is rare in cirrhotic ascites patients with malignancy. Ascites alone, without liver disease, may increase SBP risk, suggesting liver disease is crucial for SBP development.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Spontaneous bacterial peritonitis (SBP) affects approximately 8% of patients with cirrhotic ascites.
- Clinical presentation of SBP can be subtle, often manifesting as liver function decompensation.
- Ascites at Memorial Hospital is frequently associated with malignancy.
Observation:
- A review of 101 patients with malignant ascites (cytology positive) was conducted.
- Adenocarcinoma was the most common malignant diagnosis (76 patients).
- Microbiological studies were performed on 65 ascitic fluid samples.
Findings:
- Only three patients had positive ascitic fluid cultures.
- These three cases were deemed unlikely to represent true SBP.
- Ascites without liver disease appears to be a potential risk factor for SBP.
Implications:
- Liver disease, with impaired reticuloendothelial function and portasystemic shunting, may be necessary for SBP development.
- Further research is needed to elucidate the precise role of liver disease in SBP pathogenesis.
- Distinguishing SBP from other causes of peritonitis in patients with ascites is clinically important.