Background: Endocan is a potential marker of many immune-inflammatory conditions. It may be linked to liver cirrhosis. Increased endocan levels is linked to liver diseases [e.g., chronic hepatitis] which could be developed to liver decompensation and may be elevated in ascetic fluid.
Aim of the work: The current work aimed to evaluate the role of ascetic endocan in the diagnosis of Spontaneous Bacterial Peritonitis [SBP] among patients with decompensated cirrhosis.   
Patients and Methods: In this cross-sectional study, 100 patients with cirrhotic ascites were selected from patients who were admitted to Nasser institute and Al-Azhar University Hospitals during the period from April 2022 to April 2023. All patients were assessed on a clinical basis, and laboratory investigations were performed. The ascetic levels of endocan were measured and compared between groups.
Results: Both groups were comparable regarding patient demographics. All patients in non-SBP had negative culture, while 12 patients in SBP group had positive results [10 of E-Coli, one Klebsiella and one Streptococcus viridans]. The major cause of cirrhosis in both groups was the HCV [76% of SBP compared to 80% of the non-SBP group]. The endocan levels showed a significant increase in the SBP than the non-SBP groups [5.20±1.80 vs 2.96±1.80 ng/ml].  Endocan significantly and positively correlated with each of TLC, AST, ALT, creatinine, albumin, bilirubin, INR, CRP, HBsAg and HCV antibodies.  The hazardous ratio [HR] for endocan was 1.644 [95% CI: 1.011 – 2.707]. The endocan is also predictive of SBP development with an HR 1.673 [95% CI:1.031 – 2.806].
Conclusion: Ascetic Endocan is increased in ascitic fluid and represents an independent risk factor for SBP, with a significant diagnostic value in patients with decompensated cirrhosis.