A Retrospective Study of 16 Cases of Acute Compartment Syndrome Following Snakebite

Abstract

Acute compartment syndrome after snakebite is considered to be quite rare and there is still a lot of controversy in regard to its diagnosis and management as it has been reported by the little available medical literature on the topic. It is in this context that our series assumes importance as we report our experience relating to management and outcome of 16 consecutive cases of compartment syndrome from snakebites. A 15-year retrospective study was conducted on all adult patients with compartment syndrome following snakebites, who were admitted between April 2005 and December 2019 in our institution. Due to non-availability of equipment to measure intracompartmental pressure, the diagnosis of compartment syndrome was based on clinical judgment. There were 10 (62.5%) male and 6 (37.5%) female, with a mean age of 32.1 ± 7.8 years. Bite site was mostly in the lower limbs (62.5%). Based on clinical severity, 2 (12.5%), 10 (62.5%) and 4 (25%) patients were classified into classes I, II, and III, respectively. FAV-Afrique® antivenom was administered to 12 (75%) patients in doses ranging from 1 to 5 vials by patients. Fasciotomy was performed in all cases and the median time from admission to surgery was 5.8 hours (range: 4– 9hours). The mean hospital stay was 16 days and follow-up of patients has shown good results: normal limb function was regained in all cases. In summary, acute compartment syndrome following snakebite is not rare in our context and must be treated by performing early fasciotomy without any delay after diagnosis.