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KMID : 0882420080750010015
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Korean Journal of Medicine
2008 Volume.75 No. 1 p.15 ~ p.26
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Ascites and spontaneous bacterial peritonitis
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Seo Yeon-Seok
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Abstract
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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.
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KEYWORD
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Ascites, Liver cirrhosis, Paracentesis, Peritonitis
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