A Sting Beyond the Skin: Jellyfish Envenomation Presenting With Paralytic Ileus and Acute Urinary Retention.

Jellyfish envenomation typically causes localized pain and systemic reactions, but rare complications such as acute urinary retention and paralytic ileus can occur. We report a case of a 21-year-old fisherman from northern Sri Lanka who developed urinary retention and paralytic ileus following a jellyfish sting. He initially experienced severe pain and itching, followed by acute urinary retention, progressive abdominal distension, vomiting, and absent bowel opening. Imaging confirmed paralytic ileus without mechanical obstruction. The patient was managed conservatively with catheterization, bowel rest, intravenous fluids, analgesia, and nasogastric decompression, leading to full recovery within 48 hours. Although the exact mechanism remains unclear, previous studies have hypothesized that jellyfish neurotoxins may affect autonomic regulation. This study highlights the need for awareness of rare urological and gastrointestinal complications following jellyfish stings and emphasizes the importance of timely supportive management.