Ascites and SBP

 Q:  The removal of ascitic fluid helps in decreasing the odds of spontaneous bacterial peritonitis (SBP)? 

A) True

B) False

Answer: A

Removal of ascitic fluid turns ascitic fluid opsonins more concentrated. This decreases the odds of SBP. 

A less tense abdomen also protects against the development of cellulitis and abdominal wall hernia. There is also less risk of developing hydrothorax by decreasing the chances of diaphragmatic rupture. Another less known effect is reduced expenditure of energy to heat the ascitic fluid. 

 Above said, despite all these benefits, there is no solid evidence that it improves underlying mortality.

#hepatology

#ID

References:

1. Runyon BA, Van Epps DE. Diuresis of cirrhotic ascites increases its opsonic activity and may help prevent spontaneous bacterial peritonitis. Hepatology 1986; 6:396. 

2. Runyon BA, Antillon MR, McHutchison JG. Diuresis increases ascitic fluid opsonic activity in patients who survive spontaneous bacterial peritonitis. J Hepatol 1992; 14:249. 

3. Dolz C, Raurich JM, Ibáñez J, et al. Ascites increases the resting energy expenditure in liver cirrhosis. Gastroenterology 1991; 100:738.