A high voltage electrical burn of lung parenchyma

High voltage electrical trauma may cause severe visceral injuries. We repor t a case of direct electrical injury to the lung parenchyma, without eviden ce of any thoracic wall contact injury, in an electrician who sustained a 2 0 kV-electrical shock while working in a substation cubicle. The diagnosis of a true electrical burn of the left lower lobe was suggested early on by imaging and then confirmed by surgical exploration, histological findings a nd the significant improvement of the patient's condition following resecti on of the infarcted lobe. All possible causes of bronchial and pulmonary pa thologies in such a context were ruled out. The fatal outcome of two previo us similar cases and the generally high mortality of any electrical viscera l injury support early surgical management as the only rational life-saving treatment. Current pathophysiological knowledge substantiates the theory o f an isolated visceral injury located far away from the contact wounds. How ever, the pathogenesis of such severe injuries is not entirely understood. (C) 2000 Elsevier Science Ltd and ISBI. All rights reserved.