THE ASSESSMENT OF SPONTANEOUS BACTERIAL PERITONITIS (SBP) INCIDENCE IN CIRRHOTIC ASCITES PATIENTS WITH RESPECT TO AGE, GENDER & SBP MODE

Objective: Our aim of this research was to investigate the incidence of spontaneous bacterial peritonitis (SBP) in cirrhotic ascites patients. Methods: We completed this particular research on a total of one hundred cirrhotic ascites patients at Bahawal Victoria Hospital Bahawalpur from March to December 2017. History and clinical assessment helped in the study of SBP. The diagnosis was possible through cell PMN count of ascitic fluid (more than 250 / mm3) OR. There was an absence of primary infection source and positive culturing of ascitic fluid. Results: We reported Cirrhosis after Alcoholism with dominance in the male participants as only 14 females reported against 86 males with a male to female respective proportion 86% and 14%. The only male population had the incidence of SBP. The mean age of patients and SBP diagnosed patients was respectively 49.10 years and 50.58 years. In the total eighteen positive cases of SBP, fourteen had a count of PMN above 250 / mm3. E. Coli and positive staph aureus were respectively in three and one participants. During the SBP diagnosis research vomiting and fever was among 66% of the SBP diagnosed cases. Every case of abdomen pain and altered sensorium was SBP positive. No fever was in about 2.5% SBP positive cases. During the investigations of SBP associated clinical symptoms, every patient had abdominal tenderness. While making a comparison of positive Child-Pugh grading with an increase in the severity SBP also increased and there were 13 cases out of 18 with a proportion of (85.71%) who had an association with Child-Pugh Class – C; whereas, in Class – B only five cases with a proportion of (7.8%). About forty-four percent cases had a level of Ascitic Fluid Protein under (1 g/dl). The most common type of SBP was CNNA as it was available in fifteen cases (83.3 %). Conclusion: About eighteen percent of cirrhotic ascites patients had the infection of ascitic fluid which was a possible reason for SBP incidence. All the patients who presented general condition deterioration were commonly due to higher liver function derangement as the chances of SBP also increase. Level of Ascitic Protein less than (1 g/dl) in the patients may likely present the incidence of SBP than the patients having AF protein more than (1 g/dl). Cirrhosis severity increases with an increased development of SBP and also with the judged cirrhotic severity with Child-Pugh Class. Keyword: Spontaneous Bacterial Peritonitis (SBP), Cirrhosis, Pain, Abdominal Tenderness, Fever, Child-Pugh, Poly Morpho Nuclear Cells (PMN cells) and Ascitic Protein