[An anaesthesiologist's perspective on requirements for pre-surgery examinations]. / Pozadavky na predoperacní vysetrení z pohledu anesteziologa.

A preoperative check-up remains still an issue. The preoperative check-up should thoroughly evaluate an actual state of patients health, an anticipated perioperative course should be taken into account. An internist should closely collaborate not only with a surgeon, but with an anaesthesiologist as well. As guidelines cover this topic only sparsely, different approach might result either in excess or in insufficient examinations. Therefore an anaesthesia department should have its own guidelines available that would cover required preoperative check-ups considering expected operation. These guidelines should be then sent to the internist. Preoperative check-up should be done with an adequate margin before the operation, the internist should deliver a complete report including executed laboratory check-ups and consultations with specialists.

Acute pancreatitis after viperid snake cerastes cerastes envenoming: a case report.

Snakebites by the viper snake Cerastes cerastes are quite common across the world but rarely published with regard to their mostly benign course. The reported case study depicts the envenoming of a 36-year-old Czech man, a private herpetologist, who suffered snakebite to his finger. He developed a painful local reaction with hemorrhagic oedema. Subsequently, consumption coagulopathy with thrombocytopenia and haemolysis, colicky pain in the epigastrium and acute renal failure developed. Acute exudative pancreatitis was diagnosed on the third day after envenoming. Hemorrhagic oedema of the arm was complicated by a phlegmon. Symptomatic treatment including haemodialysis, fresh frozen plasma and thrombocytes was administered. Antivenom was not administered due to the delay in referral to the specialized unit. The patient recovered within one month, only postnecrotic defects of the finger persisted.