Case Of Intestinal Obstruction Research Articles

Complications of deep infiltrative endometriosis of gastrointestinal tract

Objective. To summarize the literature data on the main complications of deep infiltrative endometriosis, including ileocecal. Endometriosis is a complex disease that can begin to develop from birth. Despite all the already existing theories of the origin and development of this disease, further large-scale studies are required to investigate the etiology, pathogenesis, and phenotypes of this nosology and its relationship with pain and infertility. External genital endometriosis often affects various parts of the gastrointestinal tract. The rectosigmoid junction of the colon is most commonly affected (81.3%), followed by the appendix (6.4%), small intestine (4.7%), dome of the cecum (4.1%), and other parts of the gastrointestinal tract (1.7%). In recent years, interest in ileocecal endometriosis and its timely diagnosis and treatment has begun to grow among practicing specialists. Presently, deep infiltrative endometriosis is widely studied by obstetricians–gynecologists and by related specialists, such as general surgeons, coloproctologists, and gastroenterologists, in connection with extragenital lesions leading to severe complications. Cases of intestinal perforation caused by deep infiltrative endometriosis, bleeding, and small intestinal obstruction have been described.

A clinical case of acute intestinal obstruction as a result of dislocation of the esophageal self-expanding nitinol stent

INTRODUCTION: Covered esophageal self-expanding stents are often used to palliate dysphagia in patients with unresectable esophageal and gastric cardia cancer. Migration of an esophageal stent is a common occurrence in these patients. One of rare complications that can be caused by stent dislocation is intestinal obstruction. The article describes a case of intestinal obstruction in result of migration of a fully covered nitinol esophageal stent. Patient K., 53 years old, was admitted to hospital in a severe condition with complaints of vomiting, abdominal pain and stool retention that had persisted for four days. The patient refused esophagogastroduodenoscopy. A plain abdominal X-ray did not reveal any free gas. In the mesogastrium, numerous pneumatized loops of small intestine with horizontal fluid levels were identified. For life indications, the patient, after preoperative preparation was taken to the emergency operating room; resection of the terminal part of small intestine was performed with placement of an ileostomy and gastrostomy. Taking into account difficulties of diagnosis (refusal of esophagogastroduodenoscopy by the patient and low informative value of X-ray examination), severity of the patient’s condition (due to a malignant neoplasm and intestinal obstruction), anatomical peculiarities (location of the esophageal stent 30 cm from the ileocecal angle, which would complicate potential application of enteroenteroanastomosis), the chosen tactics was to refuse application of enteroenteroanastomosis and exteriorize ileostomy and gastrostomy. CONCLUSION: Acute intestinal obstruction is a threatening complication of migration of an esophageal stent. Patients with placed esophageal stents require careful monitoring, use of a sparing diet and additional methods of stent fixation, which will help reduce the frequency of stent migration and associated complications.

A rare case of intestinal obstruction due to tuberculosis.

A 19-year-old previously healthy patient presented with severe abdominal pain. A contrast-enhanced CT scan identified ileal obstruction and lower left lung lobe changes suggestive of an inflammatory process. Diagnostic laparoscopy revealed ileal distension, hyperemia, and whitish nodules on the serosa. Acid-fast bacilli staining was positive, confirming Mycobacterium tuberculosis infection. The patient improved with a tuberculosis regimen. Intestinal TB often affects the ileocecal area and presents with symptoms like abdominal pain and obstruction. Diagnosis is confirmed by AFB staining, and treatment mirrors pulmonary TB, though surgery may be needed for complications.

ОСЛОЖНЕННОЕ ТЕЧЕНИЕ БОЛЕЗНИ КРОНА ПРИ БЕРЕМЕННОСТИ

Crohn's disease is an inflammatory bowel disease of unknown etiology. This pathology more often affects young people, so it can occur during pregnancy and complicate its course. A case of intestinal obstruction caused by Crohn's disease during pregnancy was presented. Clinical manifestations are described; data from additional research methods and the results of morphological studies are presented. Particular emphasis is made on management of patients with acute surgical pathology during pregnancy. A brief review of the literature on this issue is presented. In the described case, the cause of intestinal obstruction was Crohn's disease, first diagnosed only during pregnancy. Complications of Crohn's disease are an indication for surgical intervention and not a reason for changing obstetric tactics: in most cases, pregnancy should be prolonged using specific therapy.

A Prospective Study on Lactate Dehydrogenase Levels in Acute Intestinal Obstruction as a Marker of Bowel Gangrene.

Background Intestinal obstruction continues to be one of the most common causes of emergencies presenting to the surgical department. A thorough clinical examination along with relevant investigations continue to be best modality for timely management and prompt decision-making in such cases. Objectives The aim of this study was to identify patients of intestinal obstruction with elevated levels of serum lactate dehydrogenase (LDH) and correlate elevated LDH levels with bowel viability. Materials and methods The study comprised 46 cases of intestinal obstruction and their serum LDH values measured prior to surgical intervention/first day of admission. The intra-operative bowel viability was noted and compared with LDH values obtained, and their correlation was studied along with other variables of the patient. Results In our study, it was found that a serum LDH level of >800 IU/L signified an abnormal bowel with increased risk of bowel gangrene, as indicated by a sensitivity of 75% and a specificity of 94%. Gangrenous bowel was found to be more associated with causes such as superior mesenteric artery/vein thrombosis, volvulus, and habits such as alcoholism and tobacco consumption. Elevated LDH levels, however, do not correlate with the length of the affected gangrenous bowel, with the duration of presentation of symptoms, or as a predictor of mortality. Conclusion Serum LDH can be used as a good predictor of gangrenous bowel in cases of intestinal obstruction.

A Case of Intestinal Obstruction Due to Reduction en Masse without Inguinal Hernia Symptoms That Was Diagnosed and Released under Laparoscopy

A Case of Intestinal Obstruction Due to Reduction en Masse without Inguinal Hernia Symptoms That Was Diagnosed and Released under Laparoscopy

A rare case of infected urachal cyst leading to intestinal obstruction in a 3-month-old boy with febrile urinary tract infection: Case report.

Urachal anomalies are rare and can present with various clinical manifestations. Urachal remnants, in particular, can be difficult to diagnose because of atypical symptoms at presentation. This study reports a case of intestinal obstruction in an infant secondary to an infected urachal cyst. A 3-month-old boy with a known febrile urinary tract infection developed acute abdominal distension. Abdominal ultrasound (US) and computed tomography (CT) revealed a nonspecific, ill-defined soft tissue density at the mid-abdomen, associated with intestinal obstruction. Emergency exploratory laparotomy was performed. The site of the obstruction was found to be at the mid-small bowel; the proximal small bowel was markedly distended, and the small bowel and sigmoid colon were adherent to urachal remnant. The urachal remnant was excised, and the peritoneal adhesions were lysed. The day after surgery, the patient was discharged without any complications. Intestinal obstruction is an exceedingly rare presentation of urachal remnants. This case highlights that urachal anomalies should be considered in the differential diagnosis in patients with intestinal obstruction and a concurrent febrile urinary tract infection.

Determining the optimal distal resection margin in rectal cancer patients by imaging of large pathological sections: An experimental study.

To determine the distal resection margin in sphincter-sparing surgery in patients with low rectal cancer based on imaging of large pathological sections. Patients who underwent sphincter-sparing surgery for ultralow rectal cancer at Guangxi Medical University Cancer Hospital within the period from January 2016 to March 2022 were tracked and observed. The clinical and pathological data of the patients were collected and analyzed. The EVOS fluorescence automatic cell imaging system was used for imaging large pathological sections. Follow-up patient data were acquired mainly by sending the patients letters and contacting them via phone calls, and during outpatient visits. A total of 46 patients (25 males, 21 females) aged 27 to 86 years participated in the present study. Regarding clinical staging, there were 9, 10, 16, and 10 cases with stages I, II, III, and IV low rectal cancer, respectively. The surgical time was 273.82 ± 111.51 minutes, the blood loss was 123.78 ± 150.91 mL, the postoperative exhaust time was 3.67 ± 1.85 days, and the postoperative discharge time was 10.36 ± 5.41 days. There were 8 patients with complications, including 3 cases of pulmonary infection, 2 cases of intestinal obstruction, one case of pleural effusion, and one case of stoma necrosis. The longest and shortest distal resection margins (distances between the cutting edges and the tumor edges) were 3 cm and 1 cm, respectively. The minimum length of the extension areas of the tumor lesions in the 46 images of large pathological sections was 0.1 mm, and the maximum length was 15 mm. Among the tumor lesions, 91.30% (42/46) had an extension area length of ≤5 mm, and 97.83% (45/46) had an extension area length of ≤10 mm. The length of the extension zone was not related to clinical pathological parameters (P > .05). In the vast majority of cases, the distal resection margin was at least 1 cm; thus, "No Evidence of Disease" could have been achieved. Additional high-powered randomized trials are needed to confirm the results of the present study.

A case of acute intestinal obstruction caused by Burkitt’s lymphoma

Acute intestinal obstruction is a multifactorial disease. Its causes may be intra-abdominal adhesions, volvulus, bezoar, gallstones, foreign bodies, intestinal tumors, etc. In rare cases, acute intestinal obstruction may be associated with intussusception, which is relatively rare in adults. The purpose of this work is to demonstrate a clinical case of acute small bowel obstruction caused by Burkitt lymphoma. During treatment for a herpetic infection, the patient underwent surgical treatment — ileostomy because of acute intestinal obstruction. In the postoperative period, the patient was hospitalized due to intestinal bleeding; during diagnostic colonoscopy, intussusception of the ileum into the ascending colon was detected; diagnostic laparoscopy, laparotomy, right-sided hemicolectomy with resection of the greater omentum, restoration of intestinal continuity with elimination of the stoma,and formation of an anastomosis were performed. The material obtained intraoperatively was sent for pathomorphological examination, including the method of fluorescent hybridization, which revealed a rearrangement of the 8th chromosome in the region of localization of the MYC gene in tumor cells, and a diagnosis of Burkitt lymphoma was established. The oncological council determined the chemotherapy treatment protocol. According to the literature, Burkitt lymphoma can debut in the cutaneous form, and it is necessary to carry out a differential diagnosis, including chickenpox. There is currently no information about intestinal complications occurring in the cutaneous form of Burkitt lymphoma. It is possible that in the described case, the initially established diagnosis of herpetic infection was incorrect, and Burkitt lymphoma occurred in the cutaneous form.

A STUDY ON INTESTINAL OBSTRUCTION REGARDING ITS EPIDEMIOLOGY, ETIOLOGY AND MANAGEMENT IN A PERIPHERAL MEDICAL COLLEGE

Objectives: The intestinal obstruction is a widespread emergency problem in our surgical practice day by day. It is a significant cause of morbidity and mortality in our health system. It is caused by adhesions, hernias, malignancies, endometriosis, inflammatory bowel disease stenosis, intussusception, and others. Our research aims to identify the etiology, epidemiology, and clinical presentations of the pathology so that we can manage the disease as early as possible for better outcomes in our peripheral institution. Methods: The study was performed on 100 cases of the age group 12–76 years admitted in the surgical ward of Midnapore Medical College and Hospital, Paschim Medinipur (W.B.) from December 2016 to June 2018. Cases of acute intestinal obstruction who underwent operation were included in our research to establish the pathology of intestinal obstruction. Results: In our study, the incidence of acute intestinal obstruction is 1.6% of total surgical cases. Maximum patients (25%) were in the age group 51– 60 years. The most common cause of intestinal obstruction was obstructed/strangulated hernia (40%). The most common symptoms were pain abdomen (88%), abdominal distension (84%), and vomiting (78%). An X-ray revealed presence of air-fluid levels in 75% of patients. The overall mortality rate was 10%. Conclusion: The morbidity and mortality of intestinal obstruction are dependent on early diagnosis, prompt resuscitation, and proper management. The critical determinants of the morbidity are age of the patient, duration of the disease, existing comorbidity, and delay in treatment. X-ray in erect view is an essential mode of diagnostic method and obstructed hernia is the most common etiology of obstruction in our research study.

Study of Etiological Spectrums, Symptoms, and Management of Intestinal Obstruction Among Population in Central India

Abstract Introduction: Intestinal obstruction has emerged as a challenging emergency putting unwanted financial as well as clinical burden globally. A study on etiology, symptoms, and management could benefit in treating larger population of the region. Aim: The study aimed to study the demography, etiology, symptoms, and management of intestinal obstruction among a population in central India. Materials and Methods: A single-center prospective observational study of intestinal obstruction was done among patients admitted to various surgical wards, during the period from January 1, 2018, to May 31, 2019. Here, we studied 50 cases of intestinal obstruction. Patients belonged to the age groups ranging from 15 to 85 years were included. Patients were selected on the basis of clinical history, physical findings, and radiological and hematological investigations. For statistical analysis, Chi-square and Fisher exact tests were performed. Results: There were a total of 12,233 admissions among which 228 cases were acute intestinal obstruction, we randomly selected 50 cases for the present study. Males were 72% (n = 36) and females were 28% (n = 14). The age groups 31–40 (20%) and 51–60 (20%) showed the highest incidence. Postoperative adhesions (40%), obstructive hernia (30%), and malignancy (14%) were the major causes of obstruction. Surgical intervention was carried out with release of adhesions in majority of cases (40%), resection anastomosis in 22%, and release of adhesions with herniorrhaphy in 18% of cases. Pain in the abdomen was a major symptom (88%) among the cases. The mortality rate was 14% of the total subjects involved in the study. Conclusion: Acute intestinal obstruction remains an important surgical emergency in the surgical field, success in the treatment depends largely upon early diagnosis and proper management and treatment of pathological effects of the obstruction. Postoperative adhesions are one of the main causes responsible for intestinal obstruction.

Small bowel obstruction caused by transmesosigmoid internal hernia

Internal hernia is an uncommon occurrence contributing to intestinal obstruction, posing diagnostic challenges. Among the infrequent manifestations, one noteworthy type is associated with the sigmoid colon, categorized into three subtypes: inter-sigmoid, trans-mesosigmoid, and intra-mesosigmoid. We present a case of a 48-year-old female who presented with small bowel obstruction as an emergency. CT showed intestinal obstruction with translational point at mid jejunum without any mass identified. At laparotomy we identified an internal hernia in the sigmoid mesocolon with full thickness mesentery defect (transmesosigmoid), bowel was viable and reduced where the defected was closed. Early identification of internal hernia and early management prevent mortality and morbidity; sigmoid related hernia is rear type of internal hernia. Most internal hernia diagnosed during laparotomy searching for case of acute intestinal obstruction.

An ingestible self-propelling device for intestinal reanimation.

Postoperative ileus (POI) is the leading cause of prolonged hospital stay after abdominal surgery and is characterized by a functional paralysis of the digestive tract, leading to symptoms such as constipation, vomiting, and functional obstruction. Current treatments are mainly supportive and inefficacious and yield acute side effects. Although electrical stimulation studies have demonstrated encouraging pacing and entraining of the intestinal slow waves, no devices exist today to enable targeted intestinal reanimation. Here, we developed an ingestible self-propelling device for intestinal reanimation (INSPIRE) capable of restoring peristalsis through luminal electrical stimulation. Optimizing mechanical, material, and electrical design parameters, we validated optimal deployment, intestinal electrical luminal contact, self-propelling capability, safety, and degradation of the device in ex vivo and in vivo swine models. We compared the INSPIRE's effect on motility in models of normal and depressed motility and chemically induced ileus. Intestinal contraction improved by 44% in anesthetized animals and up to 140% in chemically induced ileus cases. In addition, passage time decreased from, on average, 8.6 days in controls to 2.5 days with the INSPIRE device, demonstrating significant improvement in motility. Luminal electrical stimulation of the intestine via the INSPIRE efficaciously restored peristaltic activity. This noninvasive option offers a promising solution for the treatment of ileus and other motility disorders.

Myomectomy with ArtiSential fully articulating laparoscopic instruments: A prospective multicenter study.

ArtiSential, a class of innovative laparoscopic instrument, has been developed to overcome the limitations of conventional laparoscopic surgery by enabling free, 360°-unrestricted movement of the wrist joint, as in robotic surgery. The aim of the present study was to describe the initial experiences with these devices in myomectomy and to report the surgical outcomes. A total of 77 women undergoing laparoscopic or robotic myomectomy between January 2021 and June 2022 were included in this multicenter prospective study. The ArtiSential instruments used by the surgeons were those chosen according to their respective preferences. The baseline characteristics, surgical outcomes, trocar placement options, and operator survey results were scrutinized. The mean age of the patients was 39.9 ± 6.3, and the mean body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) was 22.4 ± 3.4 kg/m2; 46.8% of the patients underwent robotic surgery, while 53.2% underwent laparoscopic surgery. The number of removed myomas was 3.3 ± 3.0, the size of the largest myoma was 7.1 ± 2.3 cm, and the operative time was 130.0 ± 54.0 min. No transfusions or laparotomy conversions were required. Other than one case of ileus, there were no postoperative complications. In most cases, the instruments were inserted through the umbilicus trocar, and the fenestrated forceps, needle holder, and bipolar fenestrated forceps, in that order, were frequently employed. According to a surgeon survey, 29.9% moderately or strongly agreed that the ArtiSential devices utilized were more convenient than conventional laparoscopic instruments, while only 9.7% moderately or strongly agreed that they were more convenient than robotic instruments. Myomectomy as performed with an ArtiSential instrument seems to be feasible and safe. Further studies are necessary in order to comparatively assess the outcomes and potential benefits of ArtiSential, robotic, and conventional laparoscopic myomectomy.

P675 Comparative efficacy of Infliximab, Adalimumab, and Ustekinumab in patients with biologics naive Crohn's disease：a retrospective observational single-center study

Abstract Background The number of biologics available for Crohn's disease (CD) has increased dramatically, but there is no established standard of selection and few direct comparisons of efficacy among the agents. In this study, we compared the efficacy of infliximab (IFX), adalimumab (ADA), and ustekinumab (UST) in biologics naive CD patients. Methods A retrospective analysis of clinical data from CD patients who received IFX, ADA, and UST as 1st biologics during the period 2014-2023 was performed. Results Of 137 CD patients, 8 patients who received IFX, 17 patients who received ADA, and 10 patients who received UST as 1st biologics were included. Patient background (IFX/ADA/UST group) was as follows: median age was 32/21/22 years, median disease duration was 1/2/2 years, median HBI was 5/6/6, median SES-CD was 9/6/9, median CRP was 1.59/0.49/1.03 mg/dl, median albumin was 3.7/4.3/4.2 g /dl. Prednisolone or budesonide was concomitantly administered at induction in 5 (62.5%)/4 (23.5%)/0 (0%) patients.The cumulative remission rate (IFX/ADA/UST group) was 62.5%/58.8%/85.7% at 52 weeks after biologics induction in all patients, with a higher rate in the UST group. The steroid-free remission rates at 52 weeks (IFX/ADA/UST group) were 50.0%/58.8%/90.0%, which were higher in the UST group. For patients with HBI≥5 at the biologics induction, the remission rate after 8/16 weeks was 83.3% (5/6)/66.7% (4/6) in the IFX group, 54.5% (6/11)/63.6% (7/11) in the ADA group and 75.0% (6/8)/100% (8/8) in the UST group. There were no significant differences among all groups. Regarding adverse events, one case of skin rash and one case of dizziness were observed in the IFX group, one case of skin rash was observed in the ADA group, and no adverse event was observed in the UST group. One case of intestinal obstruction occurred in the IFX group and two cases in the ADA group, but not in the UST group. Conclusion Induction of UST in biologics naive CD patients may be as effective as anti-TNFα antibodies.

Etiology of Intestinal Obstruction - Correlation between Pre-operative and Per-operative Findings with Histopathology

Background: Intestinal obstruction is one of the most common causes of acute abdomen and often requires surgical intervention. However, pre-operative and per-operative diagnosis often do not correlate with postoperative histopathology done in suspected cases. Therefore, the study was designed to identify the etiology of intestinal obstruction correlating to pre-operative and per-operative findings with postoperative histopathological findings in suspected cases. Methods: A cross sectional study was conducted at the department of General Surgery, Mymensingh Medical College & Hospital, Mymensingh for 18 months following ethical approval from Institutional Review Board (IRB) of Mymensingh Medical College. During the study period, all patients with suspected intestinal obstruction admitted in Department of Surgery were included based on selection criteria. Total 103 patients were assessed in pre-operative and per-operatively. Histopathological examination was done in suspected cases where diagnosis could not be confirmed without histopathology. Data collection was done with a data collection form. After collection of all the required data, final analysis was carried out by using the SPSS version 21.0. Results: Among 103 cases of intestinal obstruction, mean age was 45.50±14.37 SD (years) with male female ratio-1.78:1. About 66% came from rural areas and 34% were from urban areas. Abdominal pain was the commonest symptom present among the cases which was observed in 91.3% cases. Others common symptoms were vomiting, abdominal distension absolute and relative constipation in 72.8%, 69.9%, 12.6% and 63.1% cases respectively, while abdominal tenderness was the commonest sign present in all cases. Among study population, 68.9% was small bowel obstruction and 31.1% was obstruction in large bowel. According to per-operative findings 22.3% cases were suspected as malignant. Finally 24.3% cases were proved as malignant in subsequent histopathological examination and 75.7% cases

Intestinal Obstruction Due to Ileotransverse Anastomosis Stenosis Secondary to Crohn's Disease: A Case Report

Introduction: Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract. This report explores a case of intestinal obstruction resulting from stenosis of ileotransverse anastomosis, secondary to Crohn's disease. Epidemiology: The macroscopic features of Crohn's disease vary, including patchy inflammation, ulcers, and stenosis. Stenosis is a common occurrence, particularly in the terminal ileum, affecting 30-40% of individuals with Crohn's disease. OBJECTIVE: To describe a clinical case of intestinal obstruction due to ileotransverse anastomosis stenosis secondary to Crohn's disease, aiming to recognize its behavior and determine surgical management in patients with a high suspicion of this condition. Patient and Method: A 35-year-old female diagnosed with ankylosing spondylitis, recent Crohn's disease, and intestinal obstruction. Surgical history includes exploratory laparotomy, right hemicolectomy, and ileotransverse anastomosis due to acute appendicitis. Current symptoms led to surgical exploration, revealing extensive adhesions and stenosis at the anastomosis. Results: The patient underwent resection of the affected intestinal segment and the creation of a terminal ileostomy, successfully resolving the obstruction. Comprehensive preoperative evaluation, diagnostic confirmation through imaging, and appropriate surgical intervention played critical roles in achieving a positive outcome. Discussion: The discussion emphasizes the complexities associated with Crohn's disease surgery, highlighting common complications such as infection, fistulas, and anastomotic stenosis. The case underscores the need for a cautious surgical approach and the importance of early consideration of Crohn's disease in patients with intestinal obstruction. Conclusions: This case report underscores the significance of recognizing Crohn's disease in patients presenting with intestinal obstruction. Appropriate surgical management, though challenging due to the heightened risk of complications, is essential for improving treatment outcomes. A comprehensive approach, from timely diagnosis to surgical intervention, is crucial for effectively addressing Crohn's disease manifestations and enhancing patient quality of life.

Unveiling new patterns: A surgical deep learning model for intestinal obstruction management.

Swift and accurate decision-making is pivotal in managing intestinal obstructions. This study aims to integrate deep learning and surgical expertise to enhance decision-making in intestinal obstruction cases. We developed a deep learning model based on the YOLOv8 framework, trained on a dataset of 700 images categorised into operated and non-operated groups, with surgical outcomes as ground truth. The model's performance was evaluated through standard metrics. At a confidence threshold of 0.5, the model demonstrated sensitivity of 83.33%, specificity of 78.26%, precision of 81.7%, recall of 75.1%, and mAP@0.5 of 0.831. The model exhibited promising outcomes in distinguishing operative and nonoperative management cases. The fusion of deep learning with surgical expertise enriches decision-making in intestinal obstruction management. The proposed model can assist surgeons in intricate scenarios such as intestinal obstruction management and promotes the synergy between technology and clinical acumen for advancing patient care.

Occlusion By Transmeso - Internal Hernia Congenital Sigmoid: About A Case

Internal hernia through a meso-sigmoid defect or hernia Transmesosigmoid is a rare cause of acute intestinal obstruction. Its diagnosis is most often made intraoperatively. Knowledge of its clinical particularities makes it possible to consider the preoperative diagnosis. We present 1 case of acute intestinal obstruction caused by a hernia Transmesosigmoid congenital in 1 adults. We discuss the clinical particularities of this rare form of internal hernia.

Case of intestinal obstruction by gravel in red-eared slider (Trachemys scripta elegans) solved with medicamentous therapy

Red-eared sliders (Trachemys scripta elegans) are often kept as pets, even though their sale is prohibited in many countries due the invasiveness of this species. This report describes a case of a 4-year-old red-eared slider that presented with a month-long history of lethargy and unwillingness to go into the water and was unsuccessfully treated with antibiotics and corticosteroids. Upon clinical and radiological examination, it was discovered that the patient was suffering from intestinal obstruction caused presumably by gravel stones. Medicamentous therapy consisting of meloxicam, lactulose and Ringer?s solution for reptiles was then started and the turtle managed to pass all the ingested stones via the alimentary tract. Control radiological examination has shown no signs of high-density structures in the lumen of the intestines, and the turtle has made a full recovery. With enterotomy often being considered indicated in chelonians suffering from intestinal obstruction caused by gravel, this is, to the best of the authors? knowledge, the first reported case of this kind resolved solely with medicamentous therapy in a red-eared slider.