Korean J Med.  2008 Jul;75(1):15-26.

Ascites and spontaneous bacterial peritonitis

• Seo YS

Abstract

Ascites is the most common complication of liver cirrhosis and the first presentation of hepatic decompensation in most of patients with liver cirrhosis. In addition, the development of ascites is the significant predictor for poor prognosis. The therapeutic modalities for the control of uncomplicated ascites include low sodium diet and diuretics. Spironolactone is the drug of choice for the control of cirrhotic ascites, while furosemide is generally used as an adjunct to spironolactone. In patients with refractory ascites, repeated large-volume paracentesis is the treatment choice. Spontaneous bacterial peritonitis (SBP) is the most common infection in patients with liver cirrhosis. Although inhospital mortality of patients with SBP have significantly reduced with the rapid diagnosis and choice of effective antibiotics, still 15~20% of patients died during hospitalization. Third-generation cephalosporin is the drug of choice for the treatment of SBP, which can cover about 95% of causative organisms. In patients with high-risk of SBP, prophylactic antibiotics should be considered.

Keyword

Ascites; Liver cirrhosis; Paracentesis; Peritonitis

MeSH Terms

Anti-Bacterial Agents
Ascites
Diet
Diuretics
Furosemide
Hospital Mortality
Hospitalization
Humans
Liver Cirrhosis
Paracentesis
Peritonitis
Prognosis
Sodium
Spironolactone
Anti-Bacterial Agents
Diuretics
Furosemide
Sodium
Spironolactone