Peritonitis risk factors: Difference between revisions
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{{Peritonitis}} | {{Peritonitis}} | ||
==Overview== | ==Overview== | ||
Common risk factors for peritonitis in the development of peritonitis include liver disease, [[dialysis]], and abdominal trauma. | Common risk factors for peritonitis in the development of peritonitis include liver disease, [[dialysis]], and abdominal trauma.<ref name="pmid16782626">{{cite journal| author=van Erpecum KJ| title=Ascites and spontaneous bacterial peritonitis in patients with liver cirrhosis. | journal=Scand J Gastroenterol Suppl | year= 2006 | volume= | issue= 243 | pages= 79-84 | pmid=16782626 | doi=10.1080/00365520600664342 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16782626 }} </ref> | ||
==Risk Factors== | ==Risk Factors== | ||
The following factors may increase the risk of peritonitis: | |||
* Penetrating trauma to the intestine | |||
* Twisted intestine | |||
* Inflammation of the hollow viscera of the abdomen | |||
* Surgical injuries to the abdominal viscera | |||
* Liver disease (Cirrhosis) | |||
* Pelvic inflammatory disease | |||
* Leakage of sterile body fluids into the peritoneum, such as blood (endometriosis), gastric acid (peptic ulcer), bile( liver biopsy), urine(pelvic trauma), menstruum( salpingitis),pancreatic juice (pancreatitis). | |||
* Peritoneal dialysis | |||
* Extra peritoneal tuberculous infection | |||
=== Biochemical risk factors === | === Biochemical risk factors === | ||
''Well-established risk factors for developing an initial episode of SBP are'' : | ''Well-established risk factors for developing an initial episode of SBP are'' : | ||
* Low ascitic fluid protein level (<1 g/dL) | * Low ascitic fluid protein level (<1 g/dL)<ref name="pmid20120777">{{cite journal| author=Mustafa MG, Al Mamun MA, Alam AK| title=Study on ascitic fluid protein level in cirrhotic patients with spontaneous bacterial peritonitis. | journal=Bangladesh Med Res Counc Bull | year= 2009 | volume= 35 | issue= 2 | pages= 41-3 | pmid=20120777 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20120777 }} </ref> | ||
* Elevated serum bilirubin level (>4 mg/dL) | * Elevated serum bilirubin level (>4 mg/dL) | ||
* Advanced Cirrhosis | * Advanced Cirrhosis | ||
* Low levels of 25-hydroxy vitamin D | * Low levels of 25-hydroxy vitamin D | ||
* Serum albumin level <2.85 g/dL | * Serum albumin level <2.85 g/dL | ||
=== Clinical risk factors=== | === Clinical risk factors=== | ||
* Patients with Vatical hemorrhage and GI bleeding associated with Cirrhosis are more prone to develop SBP irrespective of the presence of ascites. | * Patients with Vatical hemorrhage and GI bleeding associated with Cirrhosis are more prone to develop SBP irrespective of the presence of ascites. | ||
Latest revision as of 14:47, 30 January 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]
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Peritonitis Main Page |
Overview
Common risk factors for peritonitis in the development of peritonitis include liver disease, dialysis, and abdominal trauma.[1]
Risk Factors
The following factors may increase the risk of peritonitis:
- Penetrating trauma to the intestine
- Twisted intestine
- Inflammation of the hollow viscera of the abdomen
- Surgical injuries to the abdominal viscera
- Liver disease (Cirrhosis)
- Pelvic inflammatory disease
- Leakage of sterile body fluids into the peritoneum, such as blood (endometriosis), gastric acid (peptic ulcer), bile( liver biopsy), urine(pelvic trauma), menstruum( salpingitis),pancreatic juice (pancreatitis).
- Peritoneal dialysis
- Extra peritoneal tuberculous infection
Biochemical risk factors
Well-established risk factors for developing an initial episode of SBP are :
- Low ascitic fluid protein level (<1 g/dL)[2]
- Elevated serum bilirubin level (>4 mg/dL)
- Advanced Cirrhosis
- Low levels of 25-hydroxy vitamin D
- Serum albumin level <2.85 g/dL
Clinical risk factors
- Patients with Vatical hemorrhage and GI bleeding associated with Cirrhosis are more prone to develop SBP irrespective of the presence of ascites.
Genetic risk factors
- The Toll-like receptor 2 (TLR2) proteins[3] variants of the NOD2 (nucleotide-binding oligomerisation domain containing gene and Farnesoid X were known to cause SBP.
Pharmacological risk factors
- Proton pump inhibitors (PPI) has been associated with a three-fold increase in the risk and identified as an independent risk factor for SBP in patients with advanced cirrhosis.
- Beta-adrenergic antagonists namely nonselective beta-blocker (NSBB) therapy was found to be protective for SBP.
Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites.[4]
- Low serum sodium levels
- Child-Pugh stage C
- Elevated ascites PMN counts (≥100 cells/μl)
- MELD≥22
- Elevated CRP levels
Common risk factors for peritonitis are described as follows:[5]
| Primary Peritonitis | Secondary Peritonitis | Tertiary Peritonitis |
|---|---|---|
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References
- ↑ van Erpecum KJ (2006). "Ascites and spontaneous bacterial peritonitis in patients with liver cirrhosis". Scand J Gastroenterol Suppl (243): 79–84. doi:10.1080/00365520600664342. PMID 16782626.
- ↑ Mustafa MG, Al Mamun MA, Alam AK (2009). "Study on ascitic fluid protein level in cirrhotic patients with spontaneous bacterial peritonitis". Bangladesh Med Res Counc Bull. 35 (2): 41–3. PMID 20120777.
- ↑ Nischalke HD, Berger C, Aldenhoff K, Thyssen L, Gentemann M, Grünhage F; et al. (2011). "Toll-like receptor (TLR) 2 promoter and intron 2 polymorphisms are associated with increased risk for spontaneous bacterial peritonitis in liver cirrhosis". J Hepatol. 55 (5): 1010–6. doi:10.1016/j.jhep.2011.02.022. PMID 21356257.
- ↑ Schwabl P, Bucsics T, Soucek K, Mandorfer M, Bota S, Blacky A; et al. (2015). "Risk factors for development of spontaneous bacterial peritonitis and subsequent mortality in cirrhotic patients with ascites". Liver Int. 35 (9): 2121–8. doi:10.1111/liv.12795. PMID 25644943.
- ↑ Li PK, Szeto CC, Piraino B, de Arteaga J, Fan S, Figueiredo AE et al. (2016) ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment. Perit Dial Int 36 (5):481-508. DOI:10.3747/pdi.2016.00078 PMID: 27282851