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Case Reports
. 2023 Jun 22:10:1197446.
doi: 10.3389/fmed.2023.1197446. eCollection 2023.

Acute mesenteric ischemia following lancehead snakebite: an unusual case report in the Northernmost Brazilian Amazon

Luis E B Galan  1 , Vitória Souza Silva  1 , Vitória Santos Silva  1 , Rommel C Monte  1 , Sewbert R Jati  2   3 , Isadora S Oliveira  4   5 , Felipe A Cerni  2   3 , Wuelton M Monteiro  2   3 , Jacqueline Sachett  2   3 , Domingos S M Dantas  6 , Roberto C C Carbonell  1 , Manuela B Pucca  2   7
Affiliations
Case Reports

Acute mesenteric ischemia following lancehead snakebite: an unusual case report in the Northernmost Brazilian Amazon

Luis E B Galan et al. Front Med (Lausanne). .

Abstract

Snakebites have a great impact in the Brazilian Amazon, being the lancehead Bothrops atrox the species responsible for most accidents, disabilities, and deaths. This study shows a case report of an indigenous patient from the Yanomami ethnicity, male, 33 years-old, envenomed by a B. atrox snake. Envenoming caused by B. atrox are characterized by local manifestations (e.g., pain and edema) and systemic manifestations, mainly coagulation disorders. The indigenous victim was admitted in the main hospital of Roraima and evolved with an unusual complication, an ischemia and necrosis of the proximal ileum, requiring segmental enterectomy with posterior side-to-side anastomosis. The victim was discharge after 27 days of hospitalization with no complaints. Snakebite envenomations may evolve with life-threatening complications, which can be treated by the antivenom following access to a healthcare unit, often late in indigenous population. This clinical case shows the need of strategies that aim improvement in the access to the healthcare by indigenous people, as well as demonstrates an unusual complication that may result from lancehead snakebites. The article also discusses the decentralization of snakebites clinical management to indigenous community healthcare centers to mitigate complications.

Keywords: Amazon; Bothrops; Roraima; Yanomami; ischemia; snakebite envenoming (SBE).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Computed tomography scans. (A) Coronal view showing dilated intestinal loops (red dashed circle). (B) Axial view indicating the presence of intraluminal fluid (red arrow).
Figure 2
Figure 2
Surgical wound on the 10 postoperative day, demonstrating the healing progress at this stage.
Figure 3
Figure 3
Status of the affected limb 17 days after the snakebite accident. (A) Leg and (B) foot.
Figure 4
Figure 4
Timeline of the snakebite unusual case, illustrating the chronological sequence of events. Figure created with BioRender.com.
See this image and copyright information in PMC

References

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