Ascitic Fluid Analysis in the Differentiation of Spontaneous Bacterial Peritonitis from Gastrointestinal Tract Perforation into Ascitic Fluid

Authors

  • Bruce A. Runyon,

    Corresponding author
    1. Divisions of Gastroenterology-Hepatology, Long Beach Veterans Administration Medical Center and University of California, Irvine, California 92717
    • Bruce A. Runyon, M.D., Department of Medicine, Gastroenterology Division, University of New Mexico School of Medicine, Albuquerque, New Mexico 87131.
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  • John C. Hoefs

    1. Divisions of Gastroenterology-Hepatology, Long Beach Veterans Administration Medical Center and University of California, Irvine, California 92717
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Abstract

A review of patients with bacterial peritonitis and ascites revealed six patients with gastrointestinal tract perforation into their ascitic fluid and 33 episodes of spontaneous bacterial peritonitis in 32 patients. Signs and symptoms were not helpful in differentiating the two groups; however, ascitic fluid analysis was found to be useful. All patients with perforation peritonitis fulfilled at least two of the following criteria: ascitic fluid total protein ± 1 gm per dl, glucose < 50 mg per dl and lactate dehydrogenase ± 225 mU per ml. In only two episodes of spontaneous bacterial peritonitis were two of the criteria fulfilled.

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