[Snake bites and coagulation disorders].

Within a period of 6 years 8 patients with 12 bites by potentially hemotoxic snakes (crotalids, viperids) were hospitalised in various clinics of the Basle area. All the patients were snake owners. One patient was hospitalized 3 times, 2 patients twice and the others once. In two cases no signs of envenomation were noted after an observation period of 12 hours. Ten bites were followed by local cytotoxic symptoms e.g. oedema and suffusions. Among this group only 6 cases had further signs of systemic, hemotoxic envenomation with decrease of the activity of various coagulation factors. Complete defibrination was seen in 4 patients, but only in 2 cases with additional thrombopenia did overt clinical symptoms of bleeding complications (urological bleeding) occur. Bleeding complications of the central nervous system or of the gastrointestinal tract were not seen. Antivenin was used in three patients and coagulation mechanisms recovered within 24 hours. One patient with complete defibrination, thrombopenia and overt bleeding (macrohematuria) refused antivenin. His coagulation parameters started to improve after 7 days and became normal on day 11.