Spontaneous peri-nephric hematoma in a patient with acute kidney injury following Russell's viper envenomation.

Snake bite envenomation is a common cause of acute kidney injury (AKI) in the tropics and severe coagulopathy with bleeding manifestations is usually seen, especially with viperine bites. We present a case of a 34-year-old male who had developed AKI following Russell's viper envenomation along with disseminated intravascular coagulation. The patient was seemingly improving during the course of his treatment but subsequently developed a spontaneous unilateral peri-nephric hematoma and finally succumbed to this complication. This is a rare presentation that can be clinically innoccuous in a disease where there are multiple bleeding manifestations and, carries a very poor outcome.