Clinical manifestations of bleeding following Russell's viper and Green pit viper bites in adults.

Clinical features and laboratory investigations following bites by Russell's viper and Green pit viper were described. Bleeding was the most important manifestation of envenomation. Clinically, bleeding patterns were local and systemic. Swelling was the principal local effect. Russell' viper victims showed less local effect but frequently developed renal complication i.e. acute renal failure. The local effects were more marked in Green pit viper victims. Digital bites developed gangrene more frequently than other bitten sites. Haematemesis and bleeding gums were the commonest types of systemic bleeding. The coagulation abnormalities following Russell's viper bite were compatible with DIC. After Green pit viper bites thrombocytopenia and increased fibrinolytic activity were observed in addition to defibrination. Cerebral haemorrhage was the cause of death in one of these victims.