Spontaneous bacterial peritonitis differential diagnosis
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Spontaneous bacterial peritonitis Microchapters |
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Differentiating Spontaneous bacterial peritonitis from other Diseases |
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Diagnosis |
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Treatment |
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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]
Overview
Spontaneous bacterial peritonitis must be differentiated from other diseases that cause fever and abdominal pain, such as peritonitis, pyelonephritis, and appendicitis.
Differentiating Spontaneous bacterial peritonitis from other Diseases
Spontaneous bacterial peritonitis presents as fever and pain in the abdomen. These symptoms may also be seen in other abdominal conditions such as:
- Peritonitis - this presents as abdominal pain with guarding which is seldom seen in spontaneous bacterial peritonitis.
- Pyelonephritis - this presents as pain in the costovertebral angle.
- Appendicitis - this presents with a typical history of radiation of pain from umbilicus to McBurney's point compared to diffuse pain in spontaneous bacterial peritonitis.
- PCT level was higher in advanced Liver cirrhosis patients with SBP than CNNA which indicated it may represent as a simple biomarker for differentiating SBP from CNNA. PCT may be a prognostic predictor to guide the empirical antimicrobial therapy in order to decrease the in-hospital mortality and the frequency of complications. [1]
| Classification of acute abdomen
based on the etiology |
Pathological source of acute abdomen | Age of presentation | Typical History | Localization of the abdominal pain | Symptoms | Specific signs | Physical findings | Diagnostic tests and Lab findings | Choice of Imaging | Treatment | Other comments | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Appearance of the patient | Abdominal tenderness | Guard ing | Rigidity | Rebound tenderness | Bowel sounds | Peristalsis | |||||||||||||
| Peritonitis | Spontaneous bacterial peritonitis | ||||||||||||||||||
| Secondary peritonitis | |||||||||||||||||||
| Inflammation of the abdominal viscera | Cholecystitis | ||||||||||||||||||
| Diverticulitis | |||||||||||||||||||
| Pancreatitis | |||||||||||||||||||
| Appendicitis | |||||||||||||||||||
| Perforation of hollow viscous | Perforated peptic ulcer | ||||||||||||||||||
| Obstruction | Small intestinal obstruction | ||||||||||||||||||
| Paralytic ileus | |||||||||||||||||||
| Vascular disorders | Mesenteric ischemia | ||||||||||||||||||
| Acute ischemic colitis | |||||||||||||||||||
| Ruptured abdominal aortic aneurysm | |||||||||||||||||||
| Intraabdominal or Retroperitoneal hemorrhage | |||||||||||||||||||
References
- ↑ Wu, Hongli; Chen, Lin; Sun, Yuefeng; Meng, Chao; Hou, Wei (2016). "The role of serum procalcitonin and C-reactive protein levelsin predicting spontaneous bacterial peritonitis in patients with advanced liver cirrhosis". Pakistan Journal of Medical Sciences. 32 (6). doi:10.12669/pjms.326.10995. ISSN 1681-715X.