A Case of Spontaneous Bacterial Peritonitis Following Argon Plasma Coagulation for Angiodysplasias in the Colon

Hye Jin Jung; Soo Hyung Ryu; Kyoung Sik Park; Won Jae Yoon; Jin Nam Kim; You Sun Kim; Jeong Seop Moon

doi:10.4166/kjg.2014.64.2.115

Journal List > Korean J Gastroenterol > v.64(2) > 1007266

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Jung, Ryu, Park, Yoon, Kim, Kim, and Moon: A Case of Spontaneous Bacterial Peritonitis Following Argon Plasma Coagulation for Angiodysplasias in the Colon

Case Report

Korean J Gastroenterol 2014;64(2):115-118.

Published online: 4 October 2014

DOI: https://doi.org/10.4166/kjg.2014.64.2.115

A Case of Spontaneous Bacterial Peritonitis Following Argon Plasma Coagulation for Angiodysplasias in the Colon

Hye Jin Jung, Soo Hyung Ryu, Kyoung Sik Park, Won Jae Yoon, Jin Nam Kim, You Sun Kim, Jeong Seop Moon

Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

Correspondence to: Soo Hyung Ryu, Department of Internal Medicine, Inje University Seoul Paik Hospital, 9 Mareunnae-ro, Jung-gu, Seoul 100-032, Korea. Tel: +82-2-2270-0012, Fax: +82-2-2279-4021, E-mail: rshdrryu@medimail.co.kr

Received 16 November 2013 Revised 20 January 2014 Accepted 21 January 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Spontaneous bacterial peritonitis (SBP) is the most common infection in liver cirrhosis patients, and is not a result of surgery or intra abdominal infection. Argon plasma coagulation (APC) is an endoscopic procedure used with a high-frequency electrical current for control of bleeding from gastrointestinal vascular ectasias including angiodysplasia and gastric antral vascular ectasia. This procedure is known to be safe because it uses a noncontact method. Therefore, tissue injury is minimal and up to two to three millimeters. However, we experienced a case of SBP occurring immediately after performance of APC for control of severe bleeding from angiodysplasia in the colon in a patient with liver cirrhosis and hepatocellular carcinoma.

Keywords: Peritonitis, Argon plasma coagulation, Angiodysplasia, Liver cirrhosis

References

1. Ginés P, Rimola A, Planas R, et al. Norfloxacin prevents spontaneous bacterial peritonitis recurrence in cirrhosis: results of a double-blind, placebo-controlled trial. Hepatology. 1990; 12:716–724.

2. Silva RA, Correia AJ, Dias LM, Viana HL, Viana RL. Argon plasma coagulation therapy for hemorrhagic radiation proctosigmoiditis. Gastrointest Endosc. 1999; 50:221–224.

3. Taïeb S, Rolachon A, Cenni JC, et al. Effective use of argon plasma coagulation in the treatment of severe radiation proctitis. Dis Colon Rectum. 2001; 44:1766–1771.

4. Grund KE, Storek D, Farin G. Endoscopic argon plasma coagulation (APC) first clinical experiences in flexible endoscopy. Endosc Surg Allied Technol. 1994; 2:42–46.

5. Ben Soussan E, Mathieu N, Roque I, Antonietti M. Bowel explosion with colonic perforation during argon plasma coagulation for hemorrhagic radiation-induced proctitis. Gastrointest Endosc. 2003; 57:412–413.

6. Fernández J, Navasa M, Gómez J, et al. Bacterial infections in cirrhosis: epidemiological changes with invasive procedures and norfloxacin prophylaxis. Hepatology. 2002; 35:140–148.

7. Suzuki K, Takikawa Y. Marked improvement in the resolution of, and survival rates in, spontaneous bacterial peritonitis. J Gastroenterol. 2002; 37:149–150.

8. Garcia-Tsao G. Identifying new risk factors for spontaneous bacterial peritonitis: how important is it? Gastroenterology. 1999; 117:495–499.

9. Song HG, Lee HC, Joo YH, et al. Clinical and microbiological characteristics of spontaneous bacterial peritonitis (SBP) in a recent five year period. Taehan Kan Hakhoe Chi. 2002; 8:61–70.

10. Park MK, Lee JH, Byun YH, et al. Changes in the profiles of causative agents and antibiotic resistance rate for spontaneous bacterial peritonitis: an analysis of cultured microorganisms in recent 12 years. Korean J Hepatol. 2007; 13:370–377.

11. Seo YS, Um SH, Yim HJ, et al. Clinical features and outcomes of spontaneous bacterial peritonitis in patients with cirrhosis. Korean J Hepatol. 2007; 13(Suppl 3):S71.

12. Lee MR, Chon JY, Moon YM, Park IS, Lee KW. Efficacy of ascitic fluid culture technique using blood culture media in the diagnosis of spontaneous bacterial peritonitis. Korean J Gastroenterol. 1995; 27:659–671.

13. Bernard B, Grangé JD, Khac EN, Amiot X, Opolon P. Poynar Antibiotic prophylaxis for the prevention of bacterial infectio in cirrhotic patients with gastrointestinal bleeding: a me analysis. Hepatology. 1999; 29:1655–1661.

14. Chiu YC, Lu LS, Wu KL, et al. Comparison of argon plasma coagulation in management of upper gastrointestinal angiodysplasia and gastric antral vascular ectasia hemorrhage. BMC Gastroenterol. 2012; 12:67.

15. Poole GV. Spontaneous bacterial peritonitis during bowel preparation: an example of clinical translocation. South Med J. 1991; 84:1412–1413.

16. Gumpenberger C, Kirchgatterer A, Wallner M, Kramar R, Prischl FC. Peritonitis following argon plasma coagulation of colonic angiodysplasia in a CAPD patient–an avoidable complication? Perit Dial Int. 2005; 25:500–502.

17. Macrae FA, Tan KG, Williams CB. Towards safer colonoscopy: a report on the complications of 5000 diagnostic or therapeutic colonoscopies. Gut. 1983; 24:376–383.

18. Bunchorntavakul C, Chavalitdhamrong D. Bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. World J Hepatol. 2012; 4:158–168.

Fig. 1.

Colonoscopy findings show many small vascular malformations (angiodysplasias) over the entire colon.

Fig. 2.

Argon plasma coagulation applied on the prominent angiodysplasia suspected to cause bleeding.

TOOLS

ORCID iDs: You Sun Kim
https://orcid.org/http://orcid.org/0000-0002-5156-3458
Similar articles