What is the role of paracentesis in the evaluation of spontaneous bacterial peritonitis (SBP)?

Updated: Nov 26, 2018
  • Author: Thomas E Green, DO, MPH, MMM, CPE, FACEP, FACOEP; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

All patients suspected of having spontaneous bacterial peritonitis (SBP) must undergo peritoneal fluid analysis while in the emergency department. Diagnostic paracentesis should be performed in all patients who do not have an indwelling peritoneal catheter and are suspected of having spontaneous bacterial peritonitis. In peritoneal dialysis patients with a peritoneal catheter, fluid should be withdrawn with sterile technique. Ultrasonography may aid paracentesis if ascites is minimally detectable or questionable. Growing evidence supports early diagnostic paracentesis (defined as occurring within the first 11 hours of presentation). This, combined with early antibiotic treatment, leads to decreased ICU and hospital length of stay, in-hospital mortality, and 3-month mortality. [11, 12]


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