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Abdominal tenderness in ascites patients indicates spontaneous bacterial peritonitis

Wallerstedt, Sven; Olsson, Rolf; Simren, Magnus; Broome, Ulrika; Wahlin, Staffan; Loof, Lars; Hultcrantz, Rolf; Sjöberg, Klas LU ; Gertzen, Hanna Sandberg and Prytz, Hanne LU , et al. (2007) In European Journal of Internal Medicine 18(1). p.44-47
Abstract
Background: Spontaneous bacterial peritonitis (SBP), which has been reported to be present in 10-30% of patients with cirrhotic ascites, may easily be overlooked. An important aim of our study was to determine whether there are any clinical signs which, in clinical practice, may predict or exclude SBP. Methods: We studied 133 patients with cirrhotic ascites from medical units at nine Swedish university hospitals where there had been at least one diagnostic ascites tap with analysis of polymorphonuclear leukocytes in the ascites fluid. The patients had initially been questioned about background factors and physically examined according to a standardized case record form. Samples of blood, urine, and ascites were then drawn for analysis... (More)
Background: Spontaneous bacterial peritonitis (SBP), which has been reported to be present in 10-30% of patients with cirrhotic ascites, may easily be overlooked. An important aim of our study was to determine whether there are any clinical signs which, in clinical practice, may predict or exclude SBP. Methods: We studied 133 patients with cirrhotic ascites from medical units at nine Swedish university hospitals where there had been at least one diagnostic ascites tap with analysis of polymorphonuclear leukocytes in the ascites fluid. The patients had initially been questioned about background factors and physically examined according to a standardized case record form. Samples of blood, urine, and ascites were then drawn for analysis according to a structured schedule. Results: SBP could be excluded in 80% of all the cases and was confirmed in 8% of the 133 patients in the final analysis. Abdominal pain and abdominal tenderness were more common in patients with SBP (p<0.01), but no other physical sign or laboratory test could separate SBP cases from the others. Conclusions: SBP was present in about one-tenth of the hospitalized patients with cirrhotic ascites in this cohort. Performing repeated physical examinations and paying particular attention to abdominal tenderness may be the best way to become aware of the possible development of this complication. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. (Less)
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publication status
published
subject
keywords
spontaneous bacterial peritonitis, signs, cirrhosis, diagnosis, symptoms
in
European Journal of Internal Medicine
volume
18
issue
1
pages
44 - 47
publisher
Elsevier
external identifiers
  • wos:000244112700009
  • scopus:33846073819
ISSN
1879-0828
DOI
10.1016/j.ejim.2006.07.022
language
English
LU publication?
yes
id
e7372bc9-96e4-42c2-95a3-1dac0bf2b9a8 (old id 675224)
date added to LUP
2008-01-03 10:17:30
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2017-01-01 04:51:40
@article{e7372bc9-96e4-42c2-95a3-1dac0bf2b9a8,
  abstract     = {Background: Spontaneous bacterial peritonitis (SBP), which has been reported to be present in 10-30% of patients with cirrhotic ascites, may easily be overlooked. An important aim of our study was to determine whether there are any clinical signs which, in clinical practice, may predict or exclude SBP. Methods: We studied 133 patients with cirrhotic ascites from medical units at nine Swedish university hospitals where there had been at least one diagnostic ascites tap with analysis of polymorphonuclear leukocytes in the ascites fluid. The patients had initially been questioned about background factors and physically examined according to a standardized case record form. Samples of blood, urine, and ascites were then drawn for analysis according to a structured schedule. Results: SBP could be excluded in 80% of all the cases and was confirmed in 8% of the 133 patients in the final analysis. Abdominal pain and abdominal tenderness were more common in patients with SBP (p&lt;0.01), but no other physical sign or laboratory test could separate SBP cases from the others. Conclusions: SBP was present in about one-tenth of the hospitalized patients with cirrhotic ascites in this cohort. Performing repeated physical examinations and paying particular attention to abdominal tenderness may be the best way to become aware of the possible development of this complication. (C) 2006 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.},
  author       = {Wallerstedt, Sven and Olsson, Rolf and Simren, Magnus and Broome, Ulrika and Wahlin, Staffan and Loof, Lars and Hultcrantz, Rolf and Sjöberg, Klas and Gertzen, Hanna Sandberg and Prytz, Hanne and Almer, Sven},
  issn         = {1879-0828},
  keyword      = {spontaneous bacterial peritonitis,signs,cirrhosis,diagnosis,symptoms},
  language     = {eng},
  number       = {1},
  pages        = {44--47},
  publisher    = {Elsevier},
  series       = {European Journal of Internal Medicine},
  title        = {Abdominal tenderness in ascites patients indicates spontaneous bacterial peritonitis},
  url          = {http://dx.doi.org/10.1016/j.ejim.2006.07.022},
  volume       = {18},
  year         = {2007},
}