An unusual open pneumothorax due to high-voltage electrical burn injury: a case report.

Open intrathoracic visceral injuries are rare in electrical burns. We report the case of a 65-year-old man who sustained a high-voltage electrical burn through direct cable exposure. He arrived at the burn intensive care unit with respiratory distress secondary to an open wound on the right side of the chest wall measuring approximately 4×2 cm, with a calculated total body surface area of 2%. An immediate thoracostomy tube was placed to treat the open pneumothorax. Pneumopericardium, pneumomediastinum, and pleural infection developed later as delayed complications despite initial stabilization. After 42 days of hospitalization, the patient was discharged. This case highlights the rare occurrence of thoracic complications following electrical injury and underscores the importance of multidisciplinary, phased therapy in the management of severe electrical damage.