Isolated Liver Injury Due to Ground Current Effect of Lightning Strike

Abstract

A 26-year-old shepherd man was admitted to the emergency department in June 2020 after ground current effect of lightning strike. With the severity of the trauma, the patient fell to the ground and then fainted. Since the severity of the trauma was not known exactly, there was an open wound in the head, and the patient had dyspnea and elevated liver function tests, cranial, thorax and abdominal computed tomography (CT) were performed. On CT scan, approximately 7-cm-in length grade 3 liver laceration, extending between segment V and segment VIII was seen without intra-abdominal pathology. The patient was admitted to the intensive care unit (ICU). During the follow-up, liver function tests returned to normal. Liver laceration was managed conservatively. The patient was discharged on the 6th day of hospitalization, as no complications or massive bleeding signs were observed in the intensive care follow-up, his vital signs stabilized, and his symptoms improved.

Keywords

• Ground current
• Isolated
• Laceration
• Liver injury
• Lightning strike

References

1. 1. Schleich A, Schweiger H, Becsey A, Cruse C. Survival after severe intrathoracic electrical injury. Burns. 2010;36(5):e61.
2. 2. Elsom D. Deaths and injuries caused by lightning in the United Kingdom: analyses of two databases. Atmospheric Research. 2001;56(1-4):325-34.
3. 3. van Waes OJ, van de Woestijne PC, Halm JA. “Thunderstruck”: Penetrating Thoracic Injury From Lightning Strike. Annals of emergency medicine. 2014;63(4):457-9.
4. 4. Rotariu EL, Manole MD. Cardiac arrest secondary to lightning strike: case report and review of the literature. Pediatric emergency care. 2020;36(1):e18-e20.
5. 5. Gentges J, Schieche C. Electrical injuries in the emergency department: an evidence-based review. Emergency medicine practice. 2018;20(11):1-20.
6. 6. Anketell J, Wilson FC, McCann J. ‘Thunder bolts and lightning’: survival and neurorehabilitation following out of hospital cardiac arrest secondary to lightning strike. Brain injury. 2018;32(12):1585-7.
7. 7. Şener MU, Demir A, Şener A. Lightning-strike-induced acute lung injury: a case report. Ulus Travma Acil Cerrahi Derg. 2019;25(2):198-201.
8. 8. Jensen JD, Thurman J, Vincent AL. Lightning Injuries. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2021, StatPearls Publishing LLC.; 2021.

9. 9. Eyerly-Webb SA, Solomon R, Lee SK, Sanchez R, Carrillo EH, Davare DL, et al. Lightning burns and electrical trauma in a couple simultaneously struck by lightning. Clinical practice and cases in emergency medicine. 2017;1(3):246.
10. 10. Blumenthal R. Injuries and deaths from lightning. Journal of clinical pathology. 2021;74(5):279-84.
11. 11. Lipman GS, Gaudio FG, Eifling KP, Ellis MA, Otten EM, Grissom CK. Wilderness medical society clinical practice guidelines for the prevention and treatment of heat illness: 2019 update. Wilderness & environmental medicine. 2019;30(4):S33-S46.