ENVENIMATIONS VIPERINES

Rational:The viper envenomations are a real public health problem in Morocco more deaths are reported each year. It is a medical-surgical emergency which can be daunting and life-threatening, as well as the patients functional prognosis. Patients and Methods or Material and Methods:We present 24 cases of serious viper envenomation, on a retrospective study extended over a period of 9 years from 2010 to 2019, and through a literature review we clarify the following aspects: epidemiological, pathophysiological, clinical and therapeutic. Inclusion criteria: The presence of traces of hooks with at least one locoregional and / or general sign of envenomation. The actual presence of the snake in question and / or its description by a witness or the victim. Results:This is a retrospective study that interested 12 men and 13 women, mean age 41 years. The bites were due to vipers, the species was known cerastescerastes type in two cases, MacroviperaMauritanica in one case. 13 patients had a consumptive coagulopathy table with two cases of ischemic stroke, one case of hypovolemic shock and 4 cases of hemorrhagic shock, ten patients had compartment syndrome treated by emergency fasciotomy discharge.11 patients received anti venom serum with clinical improvement and reduction of complications. Discussion:The poison of vipers is a chemical proteinaceous with two essential components: the toxins and enzymes. These proteins are responsible for the observed symptoms. The severity of envenomation is related to the plasma concentration of the venom. The definition of early clinical and biological criteria of gravity has envenomation better assess and clarify the therapeutic indications. Processing viper envenomation considerably simplified over the past decade. The medical care is based on a symptomatic therapy component associated with a specific serum therapy. On early treatment with these specific immunoglobulins from the onset of signs of grades II or III envenomation reduces morbidity, sequelae and the total cost of care. Conclusion:Improving the prognosis of envenomation involves information education and good care that can only be achieved through close collaboration between.