Aboud Fadi, Assaf Micheal, Shtarker Haim
Department of Orthopedics A, Galillee Medical Center, 89 Nahariya-Cabri, Nahariya, Israel.
Department of Pediatric Orthopedics, Galillee Medical Center, 89 Nahariya-Cabri, Nahariya, Israel.
Trauma Case Rep. 2025 Apr 14;57:101174. doi: 10.1016/j.tcr.2025.101174. eCollection 2025 May.
Snakebites can have a diverse array of symptoms, manifesting both locally and systemically. Local symptoms include mainly swelling and pain. Rarely some patients can develop compartment syndrome. The symptoms of a snakebite can mimic those of compartment, potentially causing a delay diagnosis and treatment which can lead to devastating and a long-lasting disability. We present a case of an eight-year-old female who presented with systemic envenomation after a snakebite to her left lower leg. Upon arrival, she received supportive care, including antivenom, and demonstrated a good systemic response. However, her leg swelling and pain gradually worsened. She was examined daily by orthopedic surgeons. Clinical examinations initially showed no signs of compartment syndrome until 68 h after admission, when a passive stretch test became positive, and intra-compartmental pressure was found to be elevated. The patient was promptly taken to the operating room for compartment release. The muscles showed no ischemia and two weeks after the release primary closure was done. This case highlights the importance of clinician vigilance and awareness of the potential for delayed onset of compartment syndrome following a snakebite. Our patient was diagnosed and treated in a timely manner, resulting in complete recovery without permanent disability.
蛇咬伤可出现各种各样的症状,包括局部和全身症状。局部症状主要包括肿胀和疼痛。极少数患者会发展为骨筋膜室综合征。蛇咬伤的症状可能与骨筋膜室综合征的症状相似,这可能导致诊断和治疗延误,进而造成严重且长期的残疾。我们报告一例8岁女性患者,其左腿被蛇咬伤后出现全身中毒症状。入院后,她接受了包括抗蛇毒血清在内的支持治疗,并表现出良好的全身反应。然而,她腿部的肿胀和疼痛逐渐加重。骨科医生每天对她进行检查。临床检查最初未发现骨筋膜室综合征的迹象,直到入院68小时后,被动拉伸试验呈阳性,且发现骨筋膜室内压力升高。患者被迅速送往手术室进行骨筋膜室切开减压术。肌肉未显示缺血,切开减压术后两周进行了一期缝合。该病例强调了临床医生保持警惕并意识到蛇咬伤后骨筋膜室综合征可能延迟出现的重要性。我们的患者得到了及时诊断和治疗,最终完全康复,未留下永久性残疾。