A 21-year-old male was referred to secondary referral hospital from rural hospital with history of electrical burn injury two days before. The patient had burn injury of 32 % Total Body Surface Area (TBSA) especially on right superior extremity. Burn wound care and fasciotomy had been done on right superior extremity and right side of abdomen at the rural hospital. Physical examination revealed blood pressure of 132/96 mmHg, respiratory rate of 24 times per minute, heart rate of 99 times per minute, and body temperature of 36.4C. On arrival, patient also started complaining bloating. Abdominal x-ray showed dilation of small intestine. On the third day post-injury, patient started to complain about progressive abdominal pain with rigidity and fever. On the fourth day, the pain worsened and abdominal MSCT without contrast showed free peritoneal air. Laparotomy exploration was conducted, and intestinal fluid was found in peritoneal cavity with two ileal perforations with necrotic margin at 90 cm cranial from ileocaecal junction with diameter of 0.9 cm, and 30 cm cranial from ileocaecal junction with diameter of 0.5 cm. The surgery team did freshening and primary suturing on ileal perforation at 30 cm from ileocaecal junction and loop ileostomy at proximal of ileal perforation at 90 cm from ileocaecal junction. Further evaluation of right superior extremity showed diffuse necrosis and unmeasurable peripheral oxygen saturation. Then, the patient was referred to the burn center of tertiary referral hospital, which forequarter amputation and routine burn injury care were performed on the seventh day post-event. On the third month post-event, the ileostomy was closed (). This study is in line with the Declaration of Helsinki. Informed consent is obtained from the patient before the study and approval from institutional review board is also obtained.