Frequency and types of Spontaneous bacterial peritonitis in liver cirrhosis

Objectives: To determine the frequency and types of Spontaneous bacterial peritonitis (SBP) in patients having ascites secondary to liver cirrhosis. Material and Methods: This study was conducted in Medical E Unit of Khyber Teaching Hospital, Peshawar and Rehman Medical Institute, Peshawar from 19 ^th March, 2009 to 18 ^th September, 2009. Patients with liver cirrhosis and ascites, aged 13 years and above and of both sexes presenting with fever, chills, abdominal pain, recent increase in abdominal distension, confusion or coma, rebound tenderness or signs of hepatic encephalopathy were included. Results: SBP was detected in 128 (52.24%) patients out of 245 patients aged between 18 and 72 years included in study. Among the group of patients with SBP, 77(60.15%) were male and 51 (39.84%) were female. Classical SBP was present in 50 (39.06%), Bacterascites in 6 (4.68%) and Culture Negative Neutrocytic Ascites (CNNA) in 72 (56.25%) patients. The ascitic fluid mean total leukocyte count in patients without SBP was110.23 /mm and in patients with SBP was 2314.76 /mm. The mean ascitic fluid Polymorphonuclear (PMN) cell count in non-SBP group was 30.21/mm and in SBP group was 1760.56/mm.Conclusion: Spontaneous bacterial peritonitis is quite a common and potentially life threatening complication of liver Cirrhosis with ascites.