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Review
. 2014 Feb 22;4(1):1-6.
eCollection 2014.

Visceral injury in electrical shock trauma: proposed guideline for the management of abdominal electrocution and literature review

Evelyne Gsc Marques  1 , Gerson A Pereira Júnior  2 , Bruno F Muller Neto  1 , Rodrigo A Freitas  3 , Lygia B Yaegashi  3 , Carlos E Fagotti Almeida  1 , Jayme Adriano Farina Júnior  1
Affiliations
Review

Visceral injury in electrical shock trauma: proposed guideline for the management of abdominal electrocution and literature review

Evelyne Gsc Marques et al. Int J Burns Trauma. .

Abstract

Victims of electrical burns account for approximately 5% of admissions to major burn centers. The first case of visceral injury caused by electrical burns was described in 1927 by Simonin, who reported perforation of the small intestine. Other rare cases were reported over the following years. The colon and small intestine were the organs most frequently affected. Less frequently involved organs were the heart, esophagus, stomach, pancreas, liver, gallbladder, lung, and kidney. We highlight the potential fatal visceral injuries after the electrical trauma. This study provides a review on this topic and proposes a management flowchart that should be adopted by the multidisciplinary team to treat these patients.

Conclusion: Visceral injuries are rare in electrical burns victims, but it can be severe and are associated with high rates of morbidity and mortality, sometimes requiring a more interventional approach.

Keywords: Electrical burn; electrical shock; pancreatic injuries; visceral injuries.

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Figures

Figure 1
Figure 1
Sequential computed tomograph scans of the abdomen showing pancreatic laceration (A: arrow), edema of the pancreatic tail (B: arrow), and a left retroperitoneal hematoma (C: arrow).
Figure 2
Figure 2
Intraoperative image after exposure of the pancreas showing the laceration with charred edges at the body-tail transition.
Figure 3
Figure 3
A: Gross inspection: note the blackened areas on the surface of the pancreatic parenchyma specimen, corresponding to coagulative necrosis. B: Microscopic analysis (100x magnification): area of coagulative necrosis in the upper half of the image compared to normal parenchyma in the lower half.
Figure 4
Figure 4
Guideline proposal for the management of patients with severe electrical burns. IAP: intra-abdominal pressure; ECG: electrocardiogram; CT: computed tomography; ATLS: Advanced Trauma Life Support; ABLS: Advanced Burn Life Support; ACLS: Advanced Cardiac Life Support.
See this image and copyright information in PMC

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