著者

石田 岳史 松田 昌三 小山 隆司 栗栖 茂 大藪 久則 柴田 正樹

出版者

Japanese Association for Acute Medicine

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.6, no.4, pp.362-365, 1995-08-15 (Released:2009-03-27)

参考文献数

12

被引用文献数

2 1

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We report an unusual case of a 63-year-old man supposedly bitten by a mamushi, who developed shock, bleeding diathesis and serious hematemesis at an early stage. About 10 minutes after the mamushi bite, he fell into shock transiently, and 2 hours later, continious bleeding from the bite wound and an injection site was observed. This platelet count decreased markedly to 1.3×104/mm3 resulting in serious hematemesis. Four hours after the bite, we injected Agkistrodon halys antivenin (6, 000U) with methylpredonisolone sodium succinate 500mg and the bleeding from the bite wound and hematemesis improved remarkably. Twelve hours after the bite, the platelet count had increased to 27.1×104/mm3, and the patient had recovered from the bleeding diathesis. Mamushi bites are sometimes complicated by DIC (disseminated intravascular coagulation) as a result of massive tissue necrosis, however, there was severe thrombocytopenia and bleeding diathesis in this case, even though the local swelling and muscle necrosis were not serious. It is very important to closely monitor patients after mamushi bites, and mamushi antivenin should be used early without hesitation when these complications are observed.

著者

石田 岳史 松田 昌三 小山 隆司 栗栖 茂 大藪 久則 柴田 正樹

出版者

Japanese Association for Acute Medicine

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.6, no.4, pp.362-365, 1995-08-10

被引用文献数

4 1

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We report an unusual case of a 63-year-old man supposedly bitten by a mamushi, who developed shock, bleeding diathesis and serious hematemesis at an early stage. About 10 minutes after the mamushi bite, he fell into shock transiently, and 2 hours later, continious bleeding from the bite wound and an injection site was observed. This platelet count decreased markedly to 1.3×10⁴/mm³ resulting in serious hematemesis. Four hours after the bite, we injected Agkistrodon halys antivenin (6, 000U) with methylpredonisolone sodium succinate 500mg and the bleeding from the bite wound and hematemesis improved remarkably. Twelve hours after the bite, the platelet count had increased to 27.1×10⁴/mm³, and the patient had recovered from the bleeding diathesis. Mamushi bites are sometimes complicated by DIC (disseminated intravascular coagulation) as a result of massive tissue necrosis, however, there was severe thrombocytopenia and bleeding diathesis in this case, even though the local swelling and muscle necrosis were not serious. It is very important to closely monitor patients after mamushi bites, and mamushi antivenin should be used early without hesitation when these complications are observed.