Yasser Afif

Introduction: Electrical injuries can cause deep tissue damage with life-threatening complications, yet gastrointestinal perforation remains extremely rare. We present an unusual case of colonic perforation following high-voltage electrocution. Case Presentation: A 32-year-old male sustained a high-voltage electrical shock while climbing an electric fence. He presented with diffuse abdominal pain and burn injuries at the wrist and knee. Imaging showed pneumoperitoneum. Exploratory laparotomy revealed a transverse colon laceration and an ileal perforation. Surgical repair with colostomy and wrist aponeurotomy were successfully performed. The patient recovered well with no postoperative complications. Conclusions: This case underscores the importance of maintaining high suspicion for internal visceral injuries in electrical trauma patients, regardless of superficial burn severity. Early diagnosis and prompt surgical intervention are key to favorable outcomes.