Spontaneous bacterial peritonitis differential diagnosis

Peritonitis main page
Spontaneous bacterial peritonitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Spontaneous bacterial peritonitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
History & Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Spontaneous bacterial peritonitis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Spontaneous bacterial peritonitis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Spontaneous bacterial peritonitis differential diagnosis
CDC on Spontaneous bacterial peritonitis differential diagnosis
Spontaneous bacterial peritonitis differential diagnosis in the news
Blogs on Spontaneous bacterial peritonitis differential diagnosis
Directions to Hospitals Treating Spontaneous bacterial peritonitis
Risk calculators and risk factors for Spontaneous bacterial peritonitis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]

Overview

Spontaneous bacterial peritonitis must be differentiated from other diseases that cause fever and abdominal pain, such as peritonitis, pyelonephritis, and appendicitis.

Differentiating Spontaneous bacterial peritonitis from other Diseases

Spontaneous bacterial peritonitis presents as fever and pain in the abdomen. These symptoms may also be seen in other abdominal conditions such as:

• Peritonitis - this presents as abdominal pain with guarding which is seldom seen in spontaneous bacterial peritonitis.
• Pyelonephritis - this presents as pain in the costovertebral angle.
• Appendicitis - this presents with a typical history of radiation of pain from umbilicus to McBurney's point compared to diffuse pain in spontaneous bacterial peritonitis.
• PCT level was higher in advanced Liver cirrhosis patients with SBP than CNNA which indicated it may represent as a simple biomarker for differentiating SBP from CNNA. PCT may be a prognostic predictor to guide the empirical antimicrobial therapy in order to decrease the in-hospital mortality and the frequency of complications.

Classification of acute abdomen based on the etiology		Presentation	Age of presentation	Typical History	Localization of the abdominal pain	Symptoms	Specific signs	Physical findings									Diagnostic tests and Lab findings	Choice of Imaging	Treatment	Other comments
								Appearance of the patient/ shape of the abdomen	Abdominal tenderness	Shifting dullness	Rigidity and Guard ing	Deep tenderness	Rebound tenderness	Cough tenderness	Bump tenderness	Bowel sounds
Common causes of peritonitis	Primary peritonitis	Spontaneous bacterial peritonitis						Motionless	✔	✔	✔		✔	✔		Absent (late)
	Inflammatory disorders and perforations causing Secondary peritonitis	Perforated gastro-duodenal ulcers					Loss of liver dullness due to free air accumulating under the diaphragm	Scaphoid, tense abdomen			✔					Diminished (late)		CT scan
		Acute cholangitis
		Acute cholecystitis					Murphy sign		✔									Ultrasound
		Acute pancreatitis															Serum amylase/lipase	CT scan
		Acute appendicitis							✔									CT scan, ultrasound
		Small and large bowel perforations
		Acute diverticulitis							✔									CT scan
		Acute salpingitis
Visceral Abscess		Splenic abscess
		Hepatic abscess
Obstruction		Intestinal obstruction						Dissension of the abdomen								Hyper peristalsis (early) Visible peristalsis / quiet abdomen (late)		Flat and upright film, CT scan
		Biliary Colic
		Renal Colic
Paralytic ileus								Distension/ soft doughy fullness	✘							Minimally heard
Vascular disorders	Ischemic	Mesenteric ischemia						Soft duffy fullness	Severe pain out of proportion to examination									CT Angiogram, MRI
		Acute ischemic colitis																CT scan, Colonoscopy
	Hemorrhagic	Ruptured abdominal aortic aneurysm
		Intraabdominal or Retroperitoneal hemorrhage

References

Template:WH Template:WS