Background: Spontaneous bacterial peritonitis (SBP) is severe complication of the patients with liver cirrhosis, can also develop renal hepatic syndrome or hepatic encephalopathy. Objective: To study clinical signs and the frequency of SBP according to the severity of liver disease and the change of biochemical parameters, characteristics of ascitic fluid. Subjects and method: 37 patients with liver cirrhosis having SBP diagnosed or by an ascitic fluid polymorphonuclear neutrophil (PMN) leukocyte count of > 250 cells per mm3 and/ or microbial positive culture ascites. The conventional method of culture ascites by plating out a loop of fluid on agar plates in the microbiology laboratory. All patients were treated at Bach Mai Hospital. Results:78.4% SBP in patients with Child - Pugh C 64.9% in patients having abundant ascites fluid, 72.9% having ascitic protein < 10g/l, the very low frequency of culture - positive ascitic fluid (5.4%). The frequency clinical signs were abdominal pain (67.6%) and diarrhea (73.0%). Conclusions: Considering the SBP preventive treatment for patients with liver cirrhosis having low - protein ascites < 10g/l) and setting up ascitic fluid culture with a larger volume of ascites into aerobic and anaerobic blood culture bottles at the beside improves the sensitivity of detection of an organism.
Fibrosis ; Peritonitis/ diagnosis

A retrospective study was performed on 13 patients with spontaneous bacterial peritonitis at Viet Duc Hospital between Jan 2000 and Dec 2004. Results: Most patients with spontaneous bacterial peritonitis were diagnosed as appendix peritonitis. The rate of spontaneous bacterial peritonitis in cirrhosis patients were highest (53.8%); unknown cause 30.8%, lupus erythematosus 7.7%; 3/13 cases did not have intraoperative bacteria culture , among 7 cases had the culture results positive with gastrointestinal bacteria, E.Coli accounted for 6/7. Postoperative results: mortality rate was high (46.1%), especially in cirrhosis patients.
Peritonitis ; Diagnosis ; Therapeutics

The prospective study was conducted in 5 cases (4 males, 1 female; aged from 8 months to 76 years old) with peritonitis induced by surgery perforation of Meckel’s diverticulum at Viet Duc Hospital from January 2000 to December 2004. Clinical symptoms included abdominal pain, fever, vomiting, infection syndrome, peritoneal induction, abdominal cramp. Preoperative diagnosis: appendicitis’ peritonitis in 3 patients; appendicitis’ peritonitis induced by perforation of stomach 1 patient; peritonitis due to left bubonocele 1 patient. Results: there were 3 patients had Meckel’s diverticulum removed; 2 patients had appendix removed plus; 3 patients with anatopathology tests. There was no patients had events during surgery and postoperative complication, all 5 patients completely recovered and discharged.
Peritonitis ; Diagnosis ; Therapeutics

Background: Peritoneal tuberculosis (PT) and peritoneal malignancy (PM) are the most frequent causes of exsudate ascitic fluid but the different diagnosis between the former and the latter is also difficult and elusive. Objective: To study the difference of clinical and laparoscopic features between PT and PM. Subjects and method: 76 patients with PT and 50 with PM were diagnosed by laparoscopy and peritoneal biopsy. Ascitic mycobacterium tuberculosis was detected by PCR analysis. Exsudate ascites was confirmed according to criteria of Light. Results and Conclusions: Average age of PT was younger than of PM (p < 0.001). The frequency of fever, pleural effusion in the patients with PT was higher than those in PM (p < 0.001 and 0.05). The anemia and abdominal tumefaction in those of PM was more frequent than in those of PT (p < 0.05 and 0.001). High protein ascitic fluid and numerous lymphocytes in the patients with PT was frequent than in those with PM (p < 0.05). Laparoscopic features: In those patients with PT the white "miliary nodules" or adhesions between abdominal wall was more frequent than in those with PM (p < 0,05) and in patients with PM omental thickening, tumor formation was more than in those with PT.
Peritonitis ; Tuberculous/pathology ; diagnosis ; Laparoscopy

A retrospective study on 14 patients with diagnosis and treatment of peritonitis in Viet Duc hospital from January /2000 to December/2004. Results: Most of them have unpredictable reason of intestinal perforation. There are three groups of reason after operation: break of small intestinal cancer (leiomyosarcoma, maglinant lymphoma), tuberculosis and inflammation without specific cause. Most cases were treated appropriately with peritonitis: stitches the holes, cut the intestinal section in abdomen...however cultivate bacterium for antibiogram and it doesn’t carry out systematic, the diseases after operation due to tuberculosis haven’t treated as the standard outline. The fatality rate: 2/14 is acceptable due to both 2 patients with small intestinal cancer in weakened situation.
Peritonitis ; Intestinal Perforation ; Diagnosis ; Therapeutics

Infliximab is a chimeric monoclonal antibody against tumor necrosis factor-alpha (TNF-alpha) that is used to treat chronic inflammatory diseases such as ankylosing spondylitis (AS). Side effects include greater susceptibility to severe infections, such as tuberculosis. Positive diagnosis of tuberculous infections, such as tuberculous peritonitis, are often difficult due to the nonspecific nature of symptoms and the rarity of the infection, with definitive diagnoses requiring either a positive culture or histological biopsy. Here, we describe a case of tuberculous peritonitis during infliximab therapy in a 71-year-old man with AS; the disease was confirmed via histopathological examination.
Aged ; Biopsy ; Diagnosis ; Humans ; Peritonitis ; Peritonitis, Tuberculous* ; Spondylitis, Ankylosing* ; Tuberculosis ; Tumor Necrosis Factor-alpha ; Infliximab

Peritoneal tuberculosis is a disease rarely seen nowadays. Its symptoms are easy fatigue, abdominal distension, intermittent abdominal pain and ascites. Its onset is insidious, which si-mulates symptoms of peritonitis or carcinomatosis. Peritoneal tuberculosis should be considered in the differential diagnosis when a Patient's symptoms and signs are ascites, ovarian tumor, vague abdominal pain and abdominal distension with high serum level of CA 125, an antigenic determinant of epithelial ovarian cancers. We have recently experienced a case of peritoneal tuberculosis with markedly elevated serum level of CA 125 in 54 year-old woman and report our case with a brief review of the literature.
Abdominal Pain ; Ascites ; Carcinoma ; Diagnosis, Differential ; Fatigue ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; Peritonitis ; Peritonitis, Tuberculous*

Acute pancreatitis is an uncommon complication of CAPD. The clinical diagnosis of acute pancreatitis is difficult, since the presenting features are similar to those of dialysis associated peritonitis, and a high index of suspicion is necessary. Serum amylase values three times greater than the upper limit of normal and effluent amylase greater than 100U/L are helpful in diagnosing acute pancreatitis in CAPD patients. We report a case of pancreatitis in a patient on CAPD in whom diagnosis was made by serum amylase, effluent amylase, abdominal sonogram.
Amylases ; Diagnosis ; Dialysis ; Humans ; Pancreatitis* ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis

Peritoneal tuberculosis is a rare presentation of tuberculosis. The presenting signs and symptoms, imaging examinations and CA-125 status in peritoneal tuberculosis sometimes resemble that of ovarian cancer. Thus, the possibility of peritoneal tuberculosis should be considered in the differential diagnosis of ovarian carcinoma. We report two cases of peritoneal tuberculosis initially suspected as ovarian carcinoma but diagnosed as peritoneal tuberculosis with laparoscopy. Using diagnostic laparoscopy unnecessary laparotomy was avoided. We suggest that diagnostic laparoscopy can be helpful in differential diagnosis between peritoneal tuberculosis and ovarian carcinoma.
Diagnosis, Differential ; Laparoscopy* ; Laparotomy ; Ovarian Neoplasms ; Peritonitis, Tuberculous* ; Tuberculosis

Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.
Abdominal Pain ; Carcinoma* ; Diagnosis ; Ovarian Neoplasms ; Peritoneal Diseases ; Peritonitis, Tuberculous*