Spontaneous bacterial peritonitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Physical Examination

Appearance of the patient

• The patient may appear toxic and in distress because of pain in the abdomen.

Vital Signs

Temperature

• May have increase in temperature due to infection.
• It may decreased if disease progresses to septic shock.

Blood Pressure

• Hypertension can be seen if associated with any heart condition or renal disease.
• Hypotension can be seen in cases of volume loss due diarrhea or severe ascites.

Pulse

• May be normal or increased in rate due to infection.
• It may be low in volume due to dehydration.

Skin

• Skin over abdomen is tense due to ascites.
• Skin changes due to cirrhosis may be seen like spider nevus.

Eyes

• Jaundice may be seen in cases of liver cirrhosis.
• Periorbital puffiness may be noticed in cases of renal failure.

Neck

• Jugular venous distension may be seen in cases of heart failure causing ascites.

Heart

• Signs of heart failure may be seen like S3.

Lungs

• Signs of any infection, or signs of volume overload in lungs due to heart failure.

Abdomen

• Tense and distended abdomen is noticed.
• Tenderness on palpation.
• Shifting dullness on percussion, but it may be painful due to infection.

Neurologic

Following may be noticed when spontaneous bacterial peritonitis complicates or due to underlying liver or renal failure.

• Stupor
• Confusion
• Seizures