Colin E. Atterbury

Spontaneous meningococcal peritonitis: a report of two cases.

Two patients with spontaneous bacterial peritonitis caused byNeisseria meningitidis are described. In both cases immediate diagnosis was possible by examination of the ascitic fluid. Meningococcal peritonitis supports the hypothesis that the hematogenous spread of bacteria into the ascitic fluid may be one of the mechanisms of spontaneous bacterial peritonitis.

Portal Hypertension in Alcoholic Cirrhosis

Chronic progressive liver disease of various etiologies evolves into a final common pathway of circulatory and metabolic complications that eventually become the dominant aspects of the disease. Although the metabolic complications are themselves extensive, and in many cases life-threatening, the circulatory-related events are the most dramatic and the ones most likely to reflect the severity of the underlying liver disease. In fact, many of the metabolic abnormalities observed in chronic liver disease are initiated by a hemodynamic event: portal blood bypasses the liver through extrahepatic and intrahepatic shunts or through hepatic sinusoids that have decreased permeability both to essential nutrients and to toxins that require metabolism by the hepatocytes.1, 2