Acute compartment syndrome leading to fasciotomy, severe morbidity and long-term disabilities following Sri Lankan Green pit viper (Peltopelor trigonocephalus) envenomation

Green pit viper (Peltopelor trigonocephalus) is a medically important endemic snake in Sri Lanka. Its envenoming commonly causes local effects such as pain, swelling, blistering, and lymphadenopathy and rarely causes venom-induced consumption coagulopathy as a systemic effect. Despite its frequent encounters in estates, commonly tea and cinnamon plantations, reports of envenoming are rare and limited to nine reports in the literature. An extensive literature review confirms no previous reports of compartment syndrome following Sri Lankan Green pit viper bites. We report two cases of acute compartment syndrome leading to fasciotomy, of which, in addition, case 1 patient developed venom-induced consumption coagulopathy. [Display omitted] •Green pit viper (Peltopelor trigonocephalus) is an endemic species in Sri Lanka.•It is a highly medical important snake in Sri Lanka.•Its bite frequently causes local effects and rarely systemic manifestations.•Compartment syndrome is an uncommon complication that needs fasciotomy.