Division of Emergency Medicine, Department of Family Medicine, Steve Biko Academic Hospital, University of Pretoria, South Africa.
Trauma Unit, Department of Surgery, Steve Biko Academic Hospital, University of Pretoria, South Africa.
S Afr J Surg. 2023 Mar;61(1):14-16.
Acute limb compartment syndrome can occur with cytotoxic snake envenomation. Ultrasound (US) assessment of the affected limb has been suggested as an adjunct to the administration of snakebite polyvalent antivenom to ameliorate the systemic and local effects. US may also aid in the diagnosis of compartment syndrome and the need for fasciotomy to prevent limb loss. This report presents an adult male who had severe soft tissue swelling from a puff adder bite to the wrist and highlights the use of US in assessing and monitoring the degree of swelling in subcutaneous and fascial compartments of the arm. This US monitoring in conjunction with frequent physical examination avoided the need for a fasciotomy and its attendant morbidity, resulting in complete resolution of the swelling and full recovery of limb function.
细胞毒素蛇咬伤可导致急性肢体间隔综合征。有人建议，在使用抗蛇毒多价血清治疗的同时，采用超声（US）检查受影响的肢体，以减轻全身和局部影响。US 还可辅助诊断间隔综合征和需要切开减压以防止肢体丧失。本报告介绍了 1 例因被黄颌蛇咬伤手腕而导致严重软组织肿胀的成年男性病例，重点介绍了 US 在评估和监测手臂皮下和筋膜间隙肿胀程度中的应用。这种 US 监测与频繁的体格检查相结合，避免了切开减压及其伴随的发病率，从而使肿胀完全消退，肢体功能完全恢复。
