Surgical Correction of Evisceration and Carapacial Fracture of Three Turtles: Two Eastern Box Turtles (Terrapene carolina carolina) and One Common Snapping Turtle (Chelydra serpentina)
IAAAM 2019
Jeffrey R. Applegate, Jr.1; R. Kent Passingham1; Gregory A. Lewbart1
1College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA


Turtles that present to veterinary professionals for trauma-related causes are not unusual and perhaps far too common. Multiple retrospective surveys have evaluated case distribution on presentation of wild turtles to rescue and rehabilitation centers in the USA finding that trauma is one of the leading causes of admission and euthanasia.1,2,3,4,5 Surgical intervention for treatment of carapacial fractures has been well reported in turtles, however evisceration has previously been reported to carry a guarded prognosis6,7,8,9,10. Based on recent results, surgical correction of evisceration and shell fracture may result in a favorable outcome.11

This report summarizes the surgical management of gastrointestinal evisceration and carapacial fracture in three North Carolina, USA turtles. Two Eastern box turtles (Terrapene carolina carolina) and one common snapping turtle (Chelydra serpentina) presented within a few hours of traumatic gastric or colonic evisceration, respectively. In all cases, physical examination revealed severe carapacial fracture and a portion of the gastrointestinal tract exteriorized and entrapped by the carapacial fragments. Gastric perforation was identified and repaired in one box turtle, the stomach of the second turtle was intact, and a portion of the liver was exposed and entrapped adjacent to the colon of the snapping turtle; the section of exposed liver was ligated and removed. The exposed gastrointestinal serosa of each turtle was irrigated, replaced within the coelom and the carapacial fractures were reduced and stabilized. In each case, diagnostic imaging including contrast radiography and/or computed tomography were used to evaluate gastrointestinal luminal integrity or continuity of transit. Following treatment and rehabilitation, the carapacial fractures healed, no complications occurred secondary to the gastric or colonic exteriorization, and all were released to the wild.

Treatment and rehabilitation of free-ranging turtles following urban trauma may contribute to maintaining the wild population. Traumatic gastric or colonic evisceration of Eastern box turtles and common snapping turtle, respectively, is a survivable condition if treated appropriately. Treatment, rather than euthanasia, should be considered for turtles that suffer this condition and are intended for release to the wild population.


We thank the NCSU Turtle Rescue Team and the NCSU Diagnostic Imaging Service

Literature Cited

1.  Sack A, Butler E, Cowen P, Lewbart GA. 2017. Morbidity and mortality of wild turtles at a North Carolina wildlife clinic: a 10-year retrospective. J Zoo Wildl Med. 48(3):716–724.

2.  Brown JD, Sleeman JM. 2002. Morbidity and mortality of reptiles admitted to the Wildlife Center of Virginia, 1991 to 2000. J Wildl Dis. 38:699–705.

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5.  Schrader GM, Allender MC, Odoi A. 2010. Diagnosis, treatment, and outcome of eastern box turtles (Terrapene carolina carolina) presented to a wildlife clinic in Tennessee, USA, 1995–2007. J Wildl Dis. 46(4):1079–1085.

6.  Bogard C, Innis C. 2008. A simple and inexpensive method of shell repair in chelonia. J Herp Med Surg. 18:12–13.

7.  Heatley JJ. 2009. Chelonian shell repair. Proc ARAV. 122

8.  Kishimori J, Lewbart GA, Marcellin-Little D, Roe S, Trogdon M, Henson H, Stoskopf MK. 2001. Chelonian shell fracture repair techniques. Exotic DVM. 3(5):35–41.

9.  Mitchell MA. 2002. Diagnosis and management of reptile orthopedic injuries. In: Tully, Jr. TN, ed. Veterinary Clinics of North America: Exotic Animal Practice. WB Saunders Co, Philadelphia, PA:5(1):97–144.

10.  Fleming GJ. 2008. Clinical technique: chelonian shell repair. J Exot Pet Med. 17(4):246–258.

11.  Applegate JR Jr, Drapp RL, Lewbart GA. 2016. Nonfatal traumatic gastric evisceration in two box turtles (Terrapene carolina carolina). J Herp Med Surg. 26(3/4):80–84.


Speaker Information
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Jeffrey R. Applegate, Jr.
North Carolina State University
College of Veterinary Medicine
Raleigh, NC, USA

MAIN : Session 14: Case Reports : Evisceration & Carapacial Fracture of Turtles
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