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A CROSS SECTIONAL STUDY TO DETERMINE THE FREQUENCY OF SPONTANEOUS BACTERIAL PERITONITIS AMONG DECOMPENSATED CHRONIC LIVER DISEASE PATIENTS

Dr. Ijaz Nazir, Dr. Ghulam Mustafa, Dr Muhammad Bin Mehroze Khan

Objective: The objective of this research is to find frequency of spontaneous bacterial peritonitis in patients with decompensated chronic liver disease patients (DCLD). Methodology: Study sample was 100 patients with ascites due to chronic liver disease. Detailed clinical history was taken from all patients and complete general physical examination along with abdominopelvic examination was performed. SBP (spontaneous bacterial peritonitis) was diagnosed on basis of history, examination and investigations. Ascitic fluid analysis was done and neutrophils count more than 250/mm3 were considered diagnostic. Besides that ascetic fluid culture and presence of any source of infection was also considered diagnostic for SBP. Results: 6% of study population was male while only 14% individuals were females. Alcoholic cirrhosis was found to be a common cause. Male patients had SBP, mean age group was 49.9 years. Those with SBP belonged to 50.3 years mean age. 18 individuals had SBP, out of which 14 had neutrophils count >250/mm3. Fluid culture revealed E coli in most patients with staph. Aureus only positive in one patient. Patients were also studied with respect to presenting complains, most individuals with SBP had fever and vomiting (66%). Patients in altered state of consciousness had SBP positive in all of them (100%). Fever was not presenting complain in 2.5% patients. High Child Pugh Scoring was associated with higher incidence of SBP, 85% of total i.e. 13 out of 18 had Child Pugh class C, while only 5 patients had Child Pugh Class B. Ascitic fluid proteins <1g/dl had more chances to suffer SBP (44%). CNNA type SBP was most common (83%). Conclusion: 18% chronic liver disease ascetic individuals had SBP, it was a common sign of early deterioration of patient. Chances of SBP are associated with degree of hepatic derangements. Ascetic proteins <1g/dl had more chances of SBP. The cirrhosis severity had a strong correlation with chances of SBP, it was estimated by Child Pugh Scoring. Key Words: Cirrhosis, chronic liver disease (CLD), Spontaneous bacterial peritonitis (SBP), Child Pugh.

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