Contribution of ultrasonography to the diagnosis of internal bleeding in snakebite envenomation.

Autor: Tchaou BA; Centre Hospitalier Universitaire et Départemental du Borgou/Alibori, Parakou, Bénin., Savi de Tové KM; Centre Hospitalier Universitaire et Départemental du Borgou/Alibori, Parakou, Bénin., Sissinto-Savi de Tové Y; Centre d'Étude et de Recherche sur le Paludisme Associé à la Mère et à l'Enfant, Cotonou, Bénin., Djomga AT; Centre Hospitalier Universitaire et Départemental du Borgou/Alibori, Parakou, Bénin., Aguemon AR; Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA, Cotonou, Bénin., Massougbodji A; Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA, Cotonou, Bénin., Chippaux JP; UMR 216, Mère et enfant face aux infections tropicales, Institut de Recherche pour le Développement, Cotonou, Bénin ; Faculté de Pharmacie, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Jazyk: angličtina
Zdroj: The journal of venomous animals and toxins including tropical diseases [J Venom Anim Toxins Incl Trop Dis] 2016 Mar 16; Vol. 22, pp. 13. Date of Electronic Publication: 2016 Mar 16 (Print Publication: 2016).
DOI: 10.1186/s40409-016-0063-x
Abstrakt: Background: In Africa, snakebite envenomations are frequently complicated by life-threatening hemorrhagic syndromes. The authors of the present study conducted a prospective analysis at the University Hospital of Parakou (north of Benin) for seven months (January 1 to July 31, 2014) to assess the contribution of ultrasonography to the diagnosis of internal bleedings and management of envenomation.
Methods: An ultrasound examination was performed in all patients with clinical envenomation regardless of its severity. The study involved 32 patients admitted to the ICU of the University Hospital of Parakou.
Results: The average age was 27 ± 13.9 years. The main signs of severity were: prolongation of clotting time (88 %), severe anemia (41 %), clinical hemorrhage (47 %), and shock (19 %). The ultrasound imaging showed internal hemorrhage in 18 patients (56 %). There were hematomas (22 %), hemoperitoneum (13 %) or a combination of both (22 %). The occurrence of internal bleeding and hemoperitoneum were mainly related to the delay of hospital presentation (p = 0.007) and the existence of external bleeding (p = 0.04). Thirty patients (94 %) received antivenom. Case fatality rate was 3.1 %.
Conclusion: Ultrasonography may help in diagnosing internal bleeding, even in patients that did not show external hemorrhages, and evaluating its importance. As a consequence, the management of snakebite victims may be significantly improved.
Databáze: MEDLINE
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