Alteration in gastrointestinal and neurological function after electrical injury: a review of four cases.

Abstract

Individuals exposed to an electrical injury develop a variety of complications, several of which are recognized years after the initial electrical shock. Alteration in gastrointestinal and nervous system function has been described in these patients, yet the frequency and character of these abnormalities are poorly understood. We reviewed records of 40 individuals with a history of electrical injury to identify evidence of delayed onset of complications. Forty consecutive patients with electrical shock injuries were monitored for up to 5 yr after their traumatic event using a comprehensive systems review. Of the eight patients who described an alteration in their gastrointestinal and neurological functions, four agreed to undergo further testing. Investigations included a flexible sigmoidoscopy, anorectal manometry, stool evaluation, serological and biochemical serum analysis, and a psychological examination. Each of the four patients described an increase in stool frequency and urgency. Anorectal manometry detected a reduction in threshold to rectal balloon distention and an abnormal anal sphincter control. Bowel function improved with meselamine. Psychiatric symptoms involving memory and concentration were observed in varying degrees. To our knowledge, these induced physiological and psychological changes after exposure to electrical shock injury have not yet previously been described. Our findings should encourage further clinical investigations to better anticipate, diagnose, and manage these and other as yet unrecognized delayed complications of electrical shock injury.