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Emerg Med J. 2007 May; 24(5): 371–372.
PMCID: PMC2658502

Pneumothorax due to electrical burn injury

Deep tissue damage almost always accompanies local and regional cutaneous burn injuries, especially in electrical burns. The lungs and the heart can be affected by high‐voltage arcs in electrical injuries of the chest wall. A 14‐year‐old boy was electrocuted by an electrical current of 25 000 V. There were second‐ and third‐degree burns on 35% of the total body surface. There was also a severe burn injury extending into the subgaleal plane at the frontoparietal scalp. Respiratory distress, tachypnoea, tachycardia and right‐sided pleuritic pain ensued on day 2. Physical examination and chest x ray revealed collapse of the lungs and right‐sided pneumothorax (fig 11).). There were no fractures of the clavicle or the ribs. A closed intercostal tube drainage was applied (fig 22).). On the 10th day, the chest x ray showed regression of the pneumothorax, and auscultation revealed equal inflation of the lungs. The drain was then removed (fig 33).

figure em42978.f1
Figure 1 Right‐sided pneumothorax seen on chest x ray, two days after electrical injury.
figure em42978.f2
Figure 2 Pneumothorax has subsided after intercostal tube drainage.
figure em42978.f3
Figure 3 Ten days after removal of the chest drain; pneumothorax has resolved completely.

It is widely accepted that electrical current causes tissue damage by producing heat due to local tissue resistance.1 The main issue in electrical burns of the trunk is injuries to the viscera. Pulmonary damage due to electrical current can cause pneumothorax.2 Although visceral damage usually appears in late stages, organ perforations can occur due to disruption of visceral walls, immediately or several days after direct contact with high‐voltage electrical current. Despite the burn injury affecting the left anterior chest wall, development of pneumothorax in the right lung reflects the potential difference between different parts of the body. The probability of pneumothorax must be considered in high‐voltage electrical injuries having ports of entry on the trunk.3 Hence, it is of vital importance to closely monitor all patients with electrical injuries.

Footnotes

Competing interests: None declared.

This case report was presented at the 27th National Congress of Turkish Plastic, Reconstructive and Aesthetic Surgery, Konya, Turkey, 14–17 September, 2005.

References

1. Rai I, Jesche M G, Barrow R E. et al Electrical injuries: a 30‐ year review. J Trauma 1999. 46933–936.936 [PubMed]
2. Khan A H, Siddiqui R J, Pneumothorax due to electrical burn Indian J Chest Dis Allied Sci. 1998;40:291–293. [PubMed]
3. Sandhir R K, Tiwari I N, Goel A. Management of electrical injuries of the abdomen. Burns 1992. 18253–255.255 [PubMed]

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