Haemoperitoneum secondary to testicular rupture caused by blunt trauma in a stallion

Abstract

Summary Testicular trauma is a commonly reported consequence of injury to the scrotum in humans and horses. In the majority of cases in stallions, injury is caused by a kick from a mare during mating. This case report describes a traumatically induced unilateral testicular rupture in a stallion associated with haemoperitoneum and acute, severe signs of abdominal discomfort. Initially, testicular ultrasound and clinical examinations were inconclusive and the clinical signs led to a diagnosis of an inflammatory abdominal disorder, possibly caused by inguinoscrotal herniation. The patient underwent exploratory celiotomy with unilateral orchiectomy at which time no involvement of the gastrointestinal tract was noted (aside from the presence of haemoperitoneum) and the testicular trauma was discovered. As this case demonstrates, testicular trauma should be considered as a differential diagnosis for inguinoscrotal herniation in stallions with clinical signs of discomfort even when there is no history of recent mating. Detailed clinical examination should be performed to establish a diagnosis but may not be conclusive.

Diagnostic Approach to Equine Testicular Disorders

“…Scrotal enlargement is a common complaint and is considered to be an emergency in equine theriogenology practice [ 75 , 76 , 77 ]. The enlargement can be caused by injuries that occur during breeding, while jumping fences, or as a result of other accidents [ 76 , 77 , 78 ]. Scrotal/testicular enlargement can be acute or progressive.…”

“…The rupture of tunica albuginea and hemorrhage makes the scrotum too firm for the testes to be palpated. The severity of tissue damage may range from edema to rupture of tunica albuginea and hematocele [ 78 , 84 ]. On ultrasonography, hematocele and testicular hemorrhage are anechogenic until clot formation.…”

“…Trauma leading to testicular rupture ( Figure 15 b) and hemoperitoneum has been reported in a 13-year-old American Quarter Horse. In this case, the diagnosis was incorrectly made for inguinoscrotal hernia, highlighting the need for differential diagnosis of acute scrotal enlargement [ 78 ]. The clinical picture included colic with elevated heart and respiratory rates, hyperemic mucus membranes, increased capillary refill time, and decreased borborygmi [ 78 ].…”

“…In this case, the diagnosis was incorrectly made for inguinoscrotal hernia, highlighting the need for differential diagnosis of acute scrotal enlargement [ 78 ]. The clinical picture included colic with elevated heart and respiratory rates, hyperemic mucus membranes, increased capillary refill time, and decreased borborygmi [ 78 ]. The diagnosis was confirmed following exploratory laparotomy, and the stallion recovered after unilateral orchidectomy.…”

“…Orchitis and epididymitis are rare in stallions [ 16 , 98 , 99 ]. Orchitis can be caused by infections extending from a scrotal wound, hematogenous spread, trauma, parasites, and extension of infection from the accessory sex glands [ 16 , 78 , 98 , 100 ]. Immune-mediated orchitis is caused by traumas resulting in testicular rupture and exposure of germ cells to the circulation [ 77 ].…”