Hemoperitoneum after a<i> Bothrops</i> snakebite: Case report

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Tipo de produção
article
Data de publicação
2024
Título da Revista
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Editora
PERGAMON-ELSEVIER SCIENCE LTD
Autores
RIBEIRO, Adriana Baqueiro Abad
SANTORO, Marcelo Larami
DUARTE, Marcelo Ribeiro
VIRGULINO, Cristiana Cruz
Citação
TOXICON, v.237, article ID 107350, 5p, 2024
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Snakebites are frequent in tropical countries. Brazil has an average of 27,000 cases per year, with a fatality rate of 0.5%, and the Bothrops genus is the most common causative agent, accounting for about 70-90% of the accidents. This report describes a case of human envenomation by a juvenile Bothrops jararaca snake in Sa similar to o Paulo, Brazil, in a 71 years-old man, previously healthy. He presented a life-threatening envenomation, which developed to severe hypotension, acute kidney injury and extensive peritoneal hemorrhage. The hemoperitoneum was diagnosed due to persistent hypotension associated with anemia, pain and gastrointestinal complaints. Abdominal Computed Tomography scans showed a moderate to large amount of presumable hematic material inside the abdominal cavity, predominantly in the perihepatic and perisplenic spaces. The intra-abdominal hemorrhage was not surgically addressed, and the patient was discharged 5 days after hospitalization, with the progressive absorption of the hemoperitoneum. Systemic bleeding is one of the complications and main causes of death in Bothrops envenomations. Acute peritoneal hemorrhage is one of these serious complications that must be carefully addressed since its management must take into account the risk of bleeding caused by toxins that affect hemostasis. The case described highlights the importance of early diagnosis and adequate management of this potentially fatal complication in snakebites.
Palavras-chave
Snakebite, Bothrops envenomation, Hemoperitoneum, Peritoneal hemorrhage, Case report
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