ROSH Gastrointestinal Practice Exam

What condition is characterized by spontaneous bacterial peritonitis?

1. Chronic liver disease

2. Acute pancreatitis

3. Gastritis

4. Peptic ulcer disease

The correct answer is: Chronic liver disease

Spontaneous bacterial peritonitis (SBP) is a condition primarily associated with chronic liver disease, particularly in patients who have cirrhosis. This condition occurs when there is a translocation of bacteria from the intestinal lumen into the peritoneal cavity, often due to the compromised immune response and ascitic fluid accumulation seen in liver disease. Patients with cirrhosis are especially susceptible because their ascitic fluid provides a medium for bacterial growth, and the underlying liver dysfunction impairs the body’s ability to fight infections. In contrast, acute pancreatitis typically presents with abdominal pain and may lead to complications such as pseudocysts or necrosis, but it is not directly linked to the development of SBP. Likewise, gastritis and peptic ulcer disease are conditions that affect the gastric lining and can lead to ulceration or bleeding in the upper gastrointestinal tract, but they do not induce the kind of ascitic fluid or immune dysfunction seen in chronic liver disease that predisposes patients to SBP. Thus, chronic liver disease is correctly identified as the condition characterized by spontaneous bacterial peritonitis due to its association with ascites and increased risk of bacterial infection.