Adder bite: an uncommon cause of compartment syndrome in northern hemisphere

Abstract

Snakebite envenomation is an uncommon condition in the northern hemisphere, but requires high vigilance with regard to both the systemic effects of the venom and the locoregional impact on the soft tissues. Bites from the adder, Vipera Berus, may have serious clinical consequences due to systemic effects. A case of a 44-year-old man is reported. The patient was bitten in the right hand. He developed fasciotomy-requiring compartment syndrome of the upper limb. Recognition of this most seldom complication of an adder bite is vital to save the limb. We recommend that the classical signs and symptoms of compartment syndrome serve as indication for surgical decompression.

Figure 1

44-year old male patient presented with adder bite in his right hand with beginning swelling, picture documentation immediately after bite by patient's relatives.

Figure 2

intraoperative view of right forearm after compartment decompression (Epigard^® coverage over necrotic muscle tissue).

Figure 3

postoperative view of right forearm of the patient (2 weeks post-op, healed wound).