ASCITES AND SECONDARY BACTERIAL PERITONITIS ASSOCIATED WITH SMALL-BOWEL OBSTRUCTION

Wide albumin gradient (transudative) ascites is usually due to liver d isease but may also result from many other disorders, including heart failure, hepatic infiltration by tumor, hepatic vein thrombosis, and v enoocclusive disease. It has not been linked with small bowel obstruct ion. Narrow albumin gradient (exudative) ascites, usually due to perit oneal carcinoma or inflammation, has been noted in cases of necrotic o r perforated bowel, but simple small bowel obstruction has not previou sly been appreciated as a possible cause for ascites. We report a pati ent who developed wide albumin gradient ascites and secondary bacteria l peritonitis in association with small bowel obstruction. The small b owel obstruction, ascites, and peritonitis resolved with lysis of a si ngle abdominal adhesion.