• Dhea K. Al-Omar Al -Imam Al-Husiens teaching hospital Dep. Of medicine, College of medicine – Thi-Qar university
  • Majeed M.Al-Hammami Al -Imam Al-Husiens teaching hospital Dep. Of medicine, College of medicine – Thi-Qar university
  • Haidar M. Al-Yassiri Al -Imam Al-Husiens teaching hospital Dep. Of medicine, College of medicine – Thi-Qar university
  • Khudair H. Al-Asadi Al -Imam Al-Husiens teaching hospital Dep. Of medicine.


Background  and aims   :Coagulopathy after snake bite in Thi –Qar is one of the challenge to health services in the last  few years .different types of snakes are present ,the most dangerous one is belong to vipradea family is Echis Craniatus stimmler. Patients  and method: Retrospective  study  of patients who admitted to Al -Imam  Al-Hussiens teaching hospital  January 2002 – October 2011 ,308 , victims , (254 of  them experienced bleeding ). Results:  Female mostly were bitten in their upper limbs, while lower limbs among male. Death more among female, those who present late  . DIC is the unique cause of death. No  DIC occur after 7 days of the onset bite.  All   those  who received blood  from surviving DIC persons  were   survived. Use of  available  polyvalent Antivenom  shows decrease  mortality rate but  not statistically significant.       Discussion: Early admission  and receive  medical care may improve prognosis. Formation of auto antibodies    around    the end the  first week may explain survival  and  no death after this time  ,which also explain the benefit to those who receive their blood .Further studies needed  .


(1) Swaroop S, Grab B. Snakebite mortality in the world. Bulletin of the World Health Organization,1954, 10: 35-76.

(2) Bulletin of the World Health Organization, 1998, 76 (5): 515-52.

(3) Beer E. Fatalities due to viper-bite in Italy in the years 1951-1991. Paper presented at: First International Congress on Envenomation Treatment, Institute Pasteur, Paris, 7-9 June 1995: 137.

(4) Amr ZS, Amr SS. Snakebites in Jordan. Snake, 1983,15: 81-85.28. Efrati P. Symptomatology, pathology and treatmentof the bites of viperid snakes. In: Lee CY, ed. Snake venoms. Berlin, Springer Verlag, 1979: 956-988.

(5) Hadar H, Gitter S. The results of treatment with Pasteur antiserum in cases of snakebites. Harefuah,1959, 56: 257-261.

(6) Onuaguluchl GO. Clinical observation on snakebite in Wukari, Nigeria. Transactions of the Royal Society of Tropical Medicine and Hygiene, 1960, 54: 265- 269.

(7) D. A. WARRELL, N. McD DAVIDSON, L. D. OMEROD, HELEN M. POPE, BARBARA J. WATKINS, B. M. GREENWOOD, H. A. RIED British Medical Journal, 1974, 4, 437-440

(8) Bhat RN. Viperinesnake bite poisoning in Jammu. Joumal of the Indian Medical Association, 1974, 63: 383-392.

(9) ChippauxJP. Snakebite epidemiology in Benin (West Africa). Toxicon, 1988, 27: 37.

(10) Snow RW et al. The prevalence and morbidity of snake bite and treatment-seeking behaviour among a rural Kenyan population. Annals of tropical medicine and parasitology, 1994, 88: 665-671.

(11) Guidelinesfor the Clinical Management of Snake bites in the South-East Asia Region Reprint of the 1999 edition written and edited for SEAMEOTROPMED – Regional Centre for Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Thailand

(12) Bites by the Saw-scaled or Carpet Viper (Echis carinatus): Trial of Two Specific Antivenoms,D. A. WARRELL,et al .British Medical Journal, 1974, 4, 437-440

(13) Jae Seok Kim,Jae Won Yang, Min Soo Kim ,Seung Tae Han, Bi Ro Kim,Myung San Shin, et al. :Coagulopathy in patients who experience snakebite . Korean journal of Internal medicine,2008 June;23(2):94-99.

(14) Lee HM, Hong HP, Kim DP, Kim MC, Ko YG. Cerebral infarction following snake bite. J Korean Soc Emerg Med. 2004;15:420–425.

(15) Bawaskar HS, Bawaskar PH. Snake bite (a clinical observations). Bombay Hosp J 1992;34:190-94.

(16) Reid, H. A., Thean, P. C., and Martin, W. J. (1963 a). British Medical Journal.

(17) Ahuja, M. L., and Singh, G. (1951). Indian Journal of Medical Research, 42, 661.

(18) Bogdan GM, Dart RC. Prolonged and recurrent coagulopathy after North American pit viper envenomation (abstract). Ann Emerg Med. 1996;27:820.

(19) Boyer LV, Seifert SA, Clark RF, McNally JT, Williams SR, Nordt SP, et al. Recurrent and persistent coagulopathy following pit viper envenomation. Arch Intern Med. Apr 12 1999;159(7):706-10. [Medline].

(20) Burgess JL, Dart RC. Snake venom coagulopathy: use and abuse of blood products in the treatment of pit viper envenomation. Ann Emerg Med. Jul 1991;20(7):795-801. [Medline].

(21) Riffer E, Curry SC, Gerkin R. Successful treatment with antivenin of marked thrombocytopenia without significant coagulopathy following rattlesnake bite. Ann Emerg Med. Nov 1987;16(11):1297-9. [Medline].

(22) Harries AD, Chugh KS, Ngare B. Snake bite: frequency of adult admissions to a general hospital in north-east Nigeria. Annals of tropical medicine and parasitology, 1984, 78: 665-666.

(23) Latifi, M. (1973). In Proceedings of the Ninth International Congress on Tropical Medicine and Malaria, abstract 107. Athens, 14-21 October. Reid, H. A., Thean, P. C., and Martin, W. J. (1963 a). British Medical Journal, 2, 1378