Esophageal Stricture and Occlusion in a Green Sea Turtle (Chelonia mydas)

In December 2022, a juvenile female green sea turtle (Chelonia mydas) was stranded in North Carolina, USA. On admission to rehabilitation, physical exam and point-of-care diagnostics found severe emaciation, a healing wound to the left cranial neck, abnormal buoyancy, a heavy burden of epibiota on its carapace, anemia, and hypoproteinemia. Over time, the turtle exhibited progressive weight loss, dysphagia, and regurgitation characterized by forcefully ejecting water and masticated fish from its nares. When attempted tube feeding was unsuccessful, a cranial esophageal stricture was suspected. Computed tomography and ultrasonography revealed no evidence of an esophageal foreign body or intraluminal and extraluminal masses. Esophagoscopy confirmed a cranial esophageal stricture; however, neither bouginage nor surgical resection via an esophagostomy was successful, and the turtle was euthanized. Necropsy confirmed an esophageal stricture and occlusion, diffuse serous atrophy of fat, and widespread muscle atrophy. Histopathology revealed the esophageal stricture was comprised of focal marked fibrosis with edema and mild perivascular lymphoplasmacytic inflammation. Given the age class and size of the turtle, the authors suspect the esophageal stricture and occlusion were acquired secondary to unknown prior trauma. Esophageal stricture in sea turtles is a possible severe sequela of esophageal injury and likely carries a guarded prognosis for survival and release.