الفهرس 
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Abstract
Spontaneous bacterial peritonitis (SBP) is a serious complication of liver cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. One of the possible mechanisms of developing Spontaneous bacterial peritonitis is bacterial translocation.
Antibiotic prophylaxis is recommended for patients with liver cirrhosis at a high risk of developing SBP, gastrointestinal bleeding, or a previous episode of Spontaneous bacterial peritonitis, but the increase in the risk of developing an infection caused by multidrug-resistant organisms is a serious concern globally.
Endocan is a potential immunoinflammatory marker that may be linked to liver cirrhosis. It is a glycoprotein secreted by activated endothelial cells and is a new marker of sepsis, reflecting the extent of endothelial cell activation and injury, and it is involved in the body’s natural anti-inflammatory response.
The aim of the study is to assess the role of ascitic endocan levels in the diagnosis of SBP in decompensated cirrhosis. To elucidate this aim 90 cirrhotic patients with ascites were included in the current study and divided into 2 groups:
A. SBP group with positive ascites culture or with an AF PMNL count ≥ 250/mm3 included 45 subjects.
B. Non SBP group with negative ascites culture or with an AF PMNL count > 250/mm3 included 45 subjects .
In the SBP group, the mean age was 58.77 years with male predominance (68.8%).As regard to Non SBP group, the mean age was 59.31 years with male predominance 57.8%.
There was a statistical significant difference in between SBP group and Non-SBP group as regard to Platelets, ALT, ascetic Total leucocyte count, Protein and LDH.
The most common presentation in SBP group was Upper GIT bleeding and Abdominal pain and the most common organism detected in the culture of ascitic fluid Escherichia coli (80%) followed by Streptococcus viridans (15.5%).
Ascitic Endocan level was significantly higher in SBP group than Non-SBP group with P<0.001
The sensitivity and specificity of Ascitic Endocan in detection of SBP were 84.85% and 82.69% respectively.
There was a positive significant correlation in between Ascitic Endocan level and ALT, AST, bilirubin , CRP, Child class, MELD score, Blood Leukocytes and TLC (cell/mm3 ) in ascitic fluid in SBP group .
The significant predictors of bad outcome in patients with SBP were higher ascitic fluid Endocan level, CRP and higher Glucose in ascitic fluid (mg/dl) levels