First report of hepatic hematoma after presumed Bothrops envenomation

• Published in: Revista da Sociedade Brasileira de Medicina Tropical Vol. 48; no. 5; pp. 633 - 635
• Main Authors: Cunha, Fernanda Cristina, Heerdt, Maike, Torrez, Pasesa Pascuala Quispe, França, Francisco Oscar de Siqueira, Molin, Graziela Zibetti Dal, Battisti, Rúbia, Zannin, Marlene
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Medicina Tropical - SBMT 01.09.2015; Sociedade Brasileira de Medicina Tropical (SBMT)
• Subjects: Aged; Animals; Bothrops; Bothrops envenomation; Chemical and Drug Induced Liver Injury - diagnosis; Crotalid Venoms - poisoning; Hematoma - chemically induced; Hematoma - diagnosis; Hepatic hematoma; Humans; Male; Snakebite; Tomography, X-Ray Computed; TROPICAL MEDICINE; Snakebite; Hepatic hematoma; Bothrops envenomation
• ISSN: 0037-8682; 1678-9849; 1678-9849; 0037-8682
• DOI: 10.1590/0037-8682-0084-2015

In Latin America, Bothrops envenomation is responsible for the majority of accidents caused by venomous snakes. Patients usually present local edema, bleeding and coagulopathy. Visceral hemorrhage is extremely rare and considered a challenge for diagnosis and management. We report the first case of hepatic hematoma owing to the bothropic envenomation in a 66-year-old man who was bitten in the left leg. He presented local edema, coagulopathy, and acute kidney injury. Radiological findings suggested hepatic hematoma, with a volume of almost 3 liters. The hepatic hematoma was gradually absorbed without the need for surgical intervention with complete resolution in 8 months.