Fatal Gastro-duodenal perforation following electrocution: A Case report

A 45 yrs old male was accidentally electrocuted, while cooking on a locally made heater in his home. He was immediately brought to the hospital in unconscious state by the family members. After first aid he was referred to a tertiary care hospital, where he was admitted about two hrs after the incident. On admission he was unconscious, abdomen was distended, with fluid in peritoneal cavity. There was tachycardia and hypotension. Bowel sounds were absent. Electrocution burn marks were present over the right hand. Arterial blood analysis showed severe metabolic acidosis. He was immediately shifted to the ICU. His condition continued to be critical with persistent metabolic acidosis despite repeated sodium bicarbonate infusion. An exploratory, laprotomy was planned to rule out abdominal visceral injuries. However the patient expired six hrs after admission to the hospital before being taken to the operation theatre. Autopsy examination showed perforated anterior wall of stomach antrum and first part of duodenum.