Hemoperitoneum after a Bothrops snakebite: Case report.

Area of Science:

• Toxicology
• Clinical Medicine
• Emergency Medicine

Background:

• Snakebites are a significant public health issue in tropical regions, particularly in Brazil.
• The Bothrops genus is responsible for the majority of venomous snakebites in Brazil, leading to substantial morbidity and mortality.
• Understanding the complications of Bothrops envenomation is crucial for effective patient management.

Observation:

• A case of severe envenomation by a juvenile Bothrops jararaca in a 71-year-old man is presented.
• The patient developed life-threatening hypotension, acute kidney injury, and extensive peritoneal hemorrhage (hemoperitoneum).
• Diagnosis was confirmed by clinical presentation and abdominal CT scans revealing intra-abdominal bleeding.

Findings:

• The hemoperitoneum was managed conservatively without surgical intervention.
• The patient showed progressive absorption of the intra-abdominal blood and was discharged after 5 days.
• This case underscores the potential for severe systemic bleeding, including hemoperitoneum, in Bothrops envenomations.

Implications:

• Acute peritoneal hemorrhage is a critical and potentially fatal complication of Bothrops snakebites.
• Management requires careful consideration of coagulopathic effects of venom on hemostasis.
• Early diagnosis and appropriate, potentially non-surgical, management are vital for improving outcomes in patients with snakebite-induced hemoperitoneum.