Bacterial peritonitis after elective endoscopic variceal ligation: a prospective study

The American Journal of Gastroenterology
O S LinM S Soon

Abstract

Endoscopic variceal ligation is becoming the therapy of choice for esophageal varices, replacing endoscopic variceal sclerotherapy. The latter is associated with a 5-53% incidence of port-procedural bacteremia and a 0.5-3% incidence of peritonitis, whereas the former carries a 3-6% risk of bacteremia. However, the incidence of peritonitis after variceal ligation has not been well studied. This prospective study is designed to investigate the risk of developing bacteremia and bacterial peritonitis after elective endoscopic variceal ligation. Sixty-seven patients with esophageal varices and ascites secondary to liver cirrhosis underwent elective endoscopic variceal ligation. Before the procedure, ascitic fluid was drawn under ultrasound guidance and sent for cell counts, Gram stain, and cultures. Two to 4 days afterward, a repeat ascitic fluid sample was sent for the same studies whether or not the patient had symptoms or signs suggestive of infection. Blood cultures were drawn both immediately before and after the endoscopic ligation procedure. Of 67 subjects, 11 developed asymptomatic bacteremia with Gram-positive commensals. However, none of them progressed to peritonitis. Two patients who did not have bacteremia developed mil...Continue Reading

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Citations

Mar 19, 2004·Arquivos De Gastroenterologia·Eduardo Balzano MaulazJudite Dietz
Dec 3, 2014·Gastrointestinal Endoscopy·Mouen A KhashabBrooks D Cash
Jun 1, 2009·Clinical Journal of Gastroenterology·Alberto Di LeoFrancesco Ricci
Apr 5, 2013·Clinical Microbiology Reviews·Julia KovalevaJohn E Degener
Oct 31, 2007·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Manjushree GautamShimon Kusne
Nov 1, 2002·Current Treatment Options in Gastroenterology·Donald J. Hillebrand
Sep 7, 2020·Gastrointestinal Endoscopy Clinics of North America·Brian P H Chan, Tyler M Berzin
Mar 7, 2021·Journal of Clinical Medicine·Jorge Calderón-Parra On Behalf Of The Games Investigators

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