occurrence of spontaneous bacterial peritonitis in patients with chronic liver disease in relation to treatment modalities of upper gastrointestinal bleeding

ABSTRACT

Patients with chronic liver disease [CLD] complicated by upper gastrointestinal [UGI] bleeding are more prone to develop spontaneous bacterial peritonitis [SBP]. SBP is defined as bacterial infection of ascitic fluid in patients with CLD in the absence of an apparent intra-abdominal source of infection. The aim of this study was to determine the incidence of developing SBP in patients with CLD suffering from UGI bleeding in relation to the mode of treatment of the bleeding episode. To fulfill this aim, we studied 50 patients [34 males and 16 females], their ages ranges from 37 to 64 years with CLD and suffering UGI bleeding. Patients were prospectively randomized according to the treatment modalities of the bleeding episodes into 3 groups group A 26 patients received endoscopic variceal sclerotherapy [EVS]; group B 13 patients received endoscopic variceal ligation [EVL]; group C 11 patients received medical treatment in the form of glypressin or somatostatin. In our study the incidence of occurrence of SBP following treatment of bleeding episodes of patients with CLD was highly significant with EVS [23%] than other modalities namely EVL [7.7%] and medical treatment [0%]. Patients with CLD receiving EVS carry a significantly higher risk for developing SBP than other modalities of treatment. EVL is safer than EVS to control UGI bleeding as regard the occurrence of postendoscopic SBP