Kurtz R C, Bronzo R L
Am J Gastroenterol. 1982 Mar;77(3):146-8.
Spontaneous bacterial peritonitis is a well-described entity estimated to occur in 8% of patients with cirrhotic ascites. Characteristic clinical findings may often be absent and the only manifestation may be decompensation of liver function. Ascites at Memorial Hospital is most commonly related to malignancy. We reviewed the records of 101 patients with ascitic fluid cytology positive for malignancy during the calendar year 1979. The most common malignant cytological diagnosis was adenocarcinoma, seen in 76 patients. Of the 101 patients with positive ascitic fluid cytology, 65 fluid specimens had microbiological studies performed which included aerobic, anerobic, fungal, and acid fast bacterial cultures. Only three patients had positive ascitic fluid cultures. We believe that these three patients had other reasons for peritonitis and do not represent true spontaneous bacterial peritonitis. Ascites alone, without liver disease, seem to predispose to spontaneous bacterial peritonitis. Perhaps, the presence of liver disease with less than normally effective hepatic reticuloendothelial function and portasystemic shunting is needed for the development of spontaneous bacterial peritonitis.
自发性细菌性腹膜炎是一种已被充分描述的病症，据估计，肝硬化腹水患者中8%会发生该病。其典型的临床症状往往并不明显，唯一的表现可能是肝功能失代偿。在纪念医院，腹水最常见的病因是恶性肿瘤。我们回顾了1979年全年101例腹水细胞学检查呈恶性阳性的患者的病历。最常见的恶性细胞学诊断是腺癌，76例患者中可见。在101例腹水细胞学检查呈阳性的患者中，65份液体标本进行了微生物学研究，包括需氧菌、厌氧菌、真菌和抗酸菌培养。只有3例患者腹水培养呈阳性。我们认为这3例患者腹膜炎另有原因，并不代表真正的自发性细菌性腹膜炎。单纯腹水，无肝脏疾病，似乎易引发自发性细菌性腹膜炎。或许，自发性细菌性腹膜炎的发生需要存在肝脏疾病且肝网状内皮系统功能低于正常水平以及门体分流。
