الفهرس 
Spontaneous Bacterial PeritonitisOnly 14 pages are availabe for public view
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Abstract
Spontaneous bacterial peritonitis (SBP) is a potentially fatal
condition, characterized by infection of ascitic fluid in absence of any
intra-abdominal surgically treatable source of infection. It is the most
common infectious complication of cirrhotic patients.
SBP is a condition that requires a high index of suspicion, rapid and
accurate diagnosis in addition to prompt and effective therapy. It is also characterized by a high recurrence rate within one year of the 1st episode.
The goal of the present study was to assess the role of ascitic fluid
calprotectin in diagnosis of SBP.
For this purpose, 60 patients with decompensated liver disease were
Selected
These patients divided into:
1) Non SBP Group: include 30 patients with cirrhotic ascites without
clinical or laboratory evidence of spontaneous bacterial peritonitis.
2) SBP Group: include 30 patients with cirrhotic ascites and spontaneous bacterial peritonitis.
each patient, were subjected to:
*Full history taking and clinical examination.
*Full investigations including:
• Complete blood count.
• Liver function tests
• Kidney function tests.
•Viral markers including (HCV Abs and HBs Ag )
• Abdominal ultrasonography.
•Calculation of Child-Paugh and MELD scores.
• Diagnostic abdominal paracentesis: the ascitic fluid was subjected
to the following:
Biochemical examination.
- Cell count (total and differential leucocytic count).
-Culture and sensitivity.
- Calculation of SAAG.
• Detection of calprotectin in 1 mL ascetic fluid by Enzyme-Linked
Immuno Sorbent Assay.
The present study found that:
There was highly statistically significance increase in number of
cases presented with fever ,abdominal pain ,abdominal tenderness
and upper GIT bleeding in SBP group compared to non SBP group .
Splenomegaly and ascitic fluid turbidity were obviously appeared in
ultrasound examination of SBP group.
Culture of ascitic fluid in non SBP group showed no growth while
in SBP group there was mono organism growth and Echererchia
coli was the main infectious organism (about 55% of cases).
The majority of patients in both groups were child c (68.2% in SBP
group and 54.5% in non SBP group) .
MELD score was significantly higher in SBP group.
there was highly statistically significance increase in WBC, ALT,
AST, Total bilirubin, Prothrombin time ,INR and creatinine in SBP
group compared to non SBP group ,with statistically significance
decrease in PLT and Albumin in SBP group compared to non SBP
group.
there was a significant increase in TLC ,PMNLs ,total protein and
LDH in SBP group compared to non SBP group in ascitic fluid.
Ascitic fluid calprotectin level was statistically significant higher
in SBP group than non SBP group.
Asitic fluid calprotectin at cut-off value 3.5 ng/ml , had a
sensitivity 96.67% and a specificity 96.55%, in diagnosis of SBP
with positive predictive value 96.7 % and negative predictive value
96.6%.