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学术急诊医学档案

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  3. 卷 2 编号 3 (2014): Summer (August)
  4. Brief Report

卷 2 编号 3 (2014)

八月 2014

Diagnostic Accuracy of Ascites Fluid Gross Appearance in Detection of Spontaneous Bacterial Peritonitis

  • Hamed Aminiahidashti
  • Seyed Mohammad Hosseininejad
  • Hosein Montazer
  • Farzad Bozorgi
  • Iraj Goli khatir
  • Fateme Jahanian
  • Behnaz Raee

学术急诊医学档案, 卷 2 编号 3 (2014), 1 八月 2014 , 第 138-140 页
https://doi.org/10.22037/aaem.v2i3.122 已出版: 2014-07-21

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摘要

Introduction: Spontaneous bacterial peritonitis (SBP) as a monomicrobial infection of ascites fluid is one of the most important causes of morbidity and mortality in cirrhotic patients. This study was aimed to determine the diagnostic accuracy of ascites fluid color in detection of SBP in cirrhotic cases referred to the emergency department. Methods: Cirrhotic patients referred to the ED for the paracentesis of ascites fluid were enrolled. For all studied patients, the results of laboratory analysis and gross appearance of ascites fluid registered and reviewed by two emergency medicine specialists. The sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ration of the ascites fluid gross appearance in detection of SBP were measured with 95% confidence interval. Results: The present project was performed in 80 cirrhotic patients with ascites (52.5 female). The mean of the subjects’ age was 56.25±12.21 years (35-81). Laboratory findings revealed SBP in 23 (29%) cases. Fifty nine (73%) cases had transparent ascites fluid appearance of whom 17 (29%) ones suffered from SBP. From 21 (26%) cases with opaque ascites appearance, 15 (71%) had SBP. The sensitivity and specificity of the ascites fluid appearance in detection of SBP were 46.88% (Cl: 30.87-63.55) and 87.50% (95% Cl: 75.3-94.14), respectively. Conclusion: It seems that the gross appearance of ascites fluid had poor diagnostic accuracy in detection of SBP and considering its low sensitivity, it could not be used as a good screening tool for this propose.
关键词:
  • Peritonitis
  • ascites
  • diagnostic tests
  • routine
  • mass screening
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Aminiahidashti H, Hosseininejad SM, Montazer H, Bozorgi F, Goli khatir I, Jahanian F, 等. Diagnostic Accuracy of Ascites Fluid Gross Appearance in Detection of Spontaneous Bacterial Peritonitis. Arch Acad Emerg Med [网际网络]. 2014年7月21日 [见引于 2026年7月27日];2(3):138-40. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/122
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参考

Ginès P, Angeli P, Lenz K, et al. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53(3):397-417.

Angeloni S, Leboffe C, Parente A, et al. Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice. World J Gastroenterol. 2008;14(17):2757-62.

Lee JM, Han KH, Ahn SH. Ascites and spontaneous bacterial peritonitis: an Asian perspective. J Gastroenterol Hepatol. 2009;24(9):1494-503.

Garcia–Tsao G. Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis. Gastroenterology. 2001;120(3):726-48.

Llovet JM, Bartolí R, March F, et al. Translocated intenstinal bacteria cause spontaneous bacterial peritonitis in cirrhotic rats: molecular epidemiologic evidence. J Hepatol. 1998;28(2):307-13.

Wiest R, Garciaâ€Tsao G. Bacterial translocation (BT) in cirrhosis. Hepatology. 2005;41(3):422-33.

Terg R, Cobas S, Fassio E, et al. Oral ciprofloxacin after a short course of intravenous ciprofloxacin in the treatment of spontaneous bacterial peritonitis: results of a multicenter, randomized study. J Hepatol. 2000;33(4):564-9.

Singh N, Wagener M, Gayowski T. Changing epidemiology and predictors of mortality in patients with spontaneous bacterial peritonitis at a liver transplant unit†. Clin Microbiol Infect. 2003;9(6):531-7.

Park MK, Lee JH, Byun YH, et al. Changes in the profiles of causative agents and antibiotic resistance rate for spontaneous bacterial peritonitis: an analysis of cultured microorganisms in recent 12 years. Korean J Hepatol. 2007;13(3):370-7.

Heidari K, Amiri M, Kariman H, Bassiri M, Alimohammadi H, Hatamabadi HR. Differentiation of exudate from transudate ascites based on the dipstick values of protein, glucose, and pH. Am J Emerg Med. 2013;31(5):779-82.

Chinnock B, W Hendey G. Can clear ascitic fluid appearance rule out spontaneous bacterial peritonitis? Am J Emerg Med. 2007;25(8):934-7.

Evans LT, Kim W, Poterucha JJ, Kamath PS. Spontaneous bacterial peritonitis in asymptomatic outpatients with cirrhotic ascites. Hepatology. 2003;37(4):897-901.

Castellote J, Girbau A, Maisterra S, Charhi N, Ballester R, Xiol X. Spontaneous bacterial peritonitis and bacterascites prevalence in asymptomatic cirrhotic outpatients undergoing largeâ€volume paracentesis. J Gastroenterol Hepatol. 2008;23(2):256-9.

Romney R, Mathurin P, Ganne-Carrié N, et al. Usefulness of routine analysis of ascitic fluid at the time of therapeutic paracentesis in asymptomatic outpatients: Results of a multicenter prospective study. Gastroenterol Clin Biol. 2005;29(3):275-9.

Chinnock B, Afarian H, Minnigan H, Butler J, Hendey GW. Physician clinical impression does not rule out spontaneous bacterial peritonitis in patients undergoing emergency department paracentesis. Ann Emerg Med. 2008;52(3):268-73.

Chinnock B, Hendey GW, Minnigan H, Butler J, Afarian H. Clinical impression and ascites appearance do not rule out bacterial peritonitis. J Emerg Med. 2013;44(5):903-9.

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