Buoyancy disorder in sea turtles is a common condition that contributes to increased morbidity and mortality in the wild and because of this, is often encountered in rehabilitation facilities. The pathological gas accumulation that is a sequelae of this disorder can create challenges in treatment of this disease, especially when concurrent systemic disease is present. These challenges increase with patient size, as anatomy and location of pathology makes gas evacuation more difficult utilizing conventional methods when medical therapy alone is unsuccessful. This report discusses a novel technique utilizing ultrasonic-guided transplastron enterocentesis of the proximal gastrointestinal tract in an adult loggerhead sea turtle ( Caretta caretta ) with suspected intestinal obstruction. The sea turtle presented with positive buoyancy and routine workup revealed gas accumulation in the gastrointestinal tract, as well as concurrent pneumonia. Medical therapy alone did not diminish the positive buoyancy or gastrointestinal distension. Ultrasonic-guided transplastron enterocentesis was performed via the connective tissue lateral to the 3rd inframarginal scute while the turtle was positioned with its left side raised, allowing any gas-filled intestine to be positioned laterally. Approximately 10.3 L of gas were evacuated from the proximal gastrointestinal lumen and within 15 mins, the turtle was neutrally buoyant. It continued to exhibit normal surfacing, diving, and resting behavior. The turtle was released 111 days after enterocentesis in order to allow treatment of the concurrent pneumonia. The technique discussed in this report has implications for improving treatment of buoyancy disorder in large adult sea turtles and increasing likelihood of release.

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