Spectrum of Clinical features and risk factor Analysis in Patient of SBP with Cirrhosis and Ascites Attended in Tertiary Care Hospital of Nepal

Shrestha SL Jaishi B, Jha IK,

Abstract


Introduction: Cirrhosis and its complications like ascites and SBP are common. But studies regarding it are very few in this part of the world. So the purpose of this study is to know prevalence, presenting symptoms and risk factors of spontaneous bacterial peritonitis(SBP).

Methods: This was a cross sectional based observational study. Data were collected consecutively from January 2014 to January 2015. A total of 90 cases of ascites with cirrhosis were chosen to include in the study. Ascites without cirrhosis, any case of secondary peritonitis were excluded in the study. Patient admitted in NAMS, Bir hospital were enrolled in this study. Ascitic fluid was analyzed for diagnosis of SBP. Detail history taken, physical examination and relevant investigations had done to identify risk factors and presenting symptoms of SBP in patient of cirrhosis and ascitis.

Results: During the study period of one year a total of 90 participants were included in the study. The total number of male participants were 59(66%) and females were 31(34%). Among 90 of them 29(32.22%) has SBP. Among the 29 patients of SBP 22 of them has jaundice which is 76% (p=0.58). Fever and abdominal pain presents in 15(51%,p=0.42) patients. Hepatic encephalopathy and upper gastrointestinal bleeding consists of 12(41%) and 7(24%) (with p value 0.44) respectively. Only 3 (10%)of SBP patients were asymptomatic. Among risk factors, Out of 29 patients of SBP, 22(76%) has bilirubin more than 3mg%, 12(41%) of SBP patients have history of UGI bleeding,the ascetic protein level having one or less than one was 14(48%) and 2(6%) of them have previous history of SBP.

Conclusion: SBP incidence among hospital attending patient was 29(32.22%) in our study. Jaundice, fever and abdominal pain were common presenting symptoms. High bilirubin,UGI bleeding and low ascitic fluid total protein were associated with SBP .

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