Saudi Journal of Gastroenterology
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Year : 2014  |  Volume : 20  |  Issue : 5  |  Page : 279-287

Ascites and spontaneous bacterial peritonitis: Recommendations from two United States centers

1 Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
2 Department of Medicine, Division of Hepatology, Temple University Health System, Philadelphia, Pennsylvania, USA

Correspondence Address:
Dr. Abdullah MS Al-Osaimi
Associate Professor of Medicine and Surgery, Division Chief of Hepatology, Medical Director of Liver Transplantation, Temple University Health System, 3440 N. Broad Street, Kresge Building West, Room 216, Philadelphia, Pennsylvania - 19103
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Source of Support: None, Conflict of Interest: The opinions and assertions contained herein are the sole views of the authors and are not to be construed as official or as reflecting the views of the Cedars-Sinai Medical Center or Temple University Health System.

DOI: 10.4103/1319-3767.141686

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Cirrhosis affects millions of people throughout the world. Two of the most serious complications of liver cirrhosis are ascites and spontaneous bacterial peritonitis (SBP). The development of ascites is related to the severity of portal hypertension and is an indicator of increased mortality. Although sodium restriction and diuretic therapy have proven effective, some patients may not respond appropriately or develop adverse reactions to diuretic therapy. In such cases, interventions such as transjugular intrahepatic portosystemic shunt (TIPS) placement are warranted. SBP is a complication of ascites that confers a very high mortality rate. Recognition and prompt treatment of this condition is essential to prevent serious morbidity and mortality. Initiation of prophylaxis in SBP remains controversial. Given the burden of liver cirrhosis on the health care system, ascites and SBP will continue to provide challenges for the primary care provider, hospitalist, internist, and gastroenterologist alike.

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