الفهرس 
Cirrhosis
Grading of ascitesOnly 14 pages are availabe for public view
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Abstract
Spontaneous bacterial peritonitis (SBP) occurs in up to 30% of
patients with cirrhosis and has an estimated in-hospital mortality rate
of 20%. The prevalence of SBP in cirrhotic outpatients is 1.5 to 3.5%
and among inpatients is approximately 10%.
SBP is an infection of ascites characteristic of the cirrhotic
patient that occurs in the absence of hollow viscus perforation and in
the absence of an intra-abdominal inflammatory focus such as an
abscess, acute pancreatitis, or cholecystitis.
In most instances, SBP results from translocation of bacteria
from the intestinal lumen. Less often, SBP results from bacteremia that
originates at a distant site, such as a urinary tract infection. Most cases
of SBP are caused by gram-negative enteric organisms, such as
Escherichia coli and Klebsiella pneumoniae.
Risk factors for the development of SBP include ascitic fluid
total protein less than 1 g/dL, gastrointestinal hemorrhage, and
previous history of SBP. Ascitic fluid analysis is the key diagnostic
procedure of SBP.
Platelets are considered an important source of prothrombotic
agents associated with inflammatory markers and play a role in the
initiation and propagation of vascular and inflammatory diseases.
Platelets with large size have many granules that can exert their
hemostatic and proinflammatory actions with greater efficiency.
Mean platelet volume (MPV) and platelet distribution width
(PDW) may be considered as simple and inexpensive indicators of
inflammation in some diseases.