Objective:
Describing the clinical features and associated biochemical abnormalities in patients treated for Deinagkistrodon acutus snakebite in eastern Taiwan to increase understanding of the outcomes and treatments.

Materials and Methods:
This is a retrospective and descriptive study of case series. The analysis of 15 patients with snakebite by D. acutus treated at Hualien Tzu Chi Hospital from January 2001 to December 2021.

Results:
Most common local signs of D. acutus snakebite were swelling, tenderness, erythema and ecchymosis, even hemorrhagic bullae, beyond bitten site. Thrombocytopenia and coagulopathy were noted. However, coagulopathy was rapidly corrected under antivenin use and blood transfusion within 24 hours. It isn’t characterized by systemic microthrombi and end-organ failure, differentiating from DIC. Besides, 6 cases presented compartment syndrome and all of them received fasciotomy within 24 hours(further reconstruction: one for repair, four for skin graft and one for free flap).

Conclusion:
In view of rare cases of D. acutus snakebite in Taiwan, these clinical and biochemical features in 15 patients are helpful for evaluations and managements. Moreover, D. acutus envenomation causes coagulopathy and/or thrombocytopenia, differentiating from DIC. High proportion of cases presented compartment syndrome and needed to receive fasciotomy and reconstruction. These clinical findings lead to better understanding of the effects of snakebite by D. acutus.

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