Page 583 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

558 CHAPTER 2

VetBooks.ir (changed every few days) may result in resolution Aetiology/pathophysiology
Sperm that have escaped the seminiferous tubules,
within 2 weeks. If manual reduction is not possible,
a ruptured hernia is likely or the hernia becomes
resulting in a granulomatous reaction around them.
incarcerated, and surgical or laparoscopic reduction excurrent ducts or eipididymis are highly antigenic,
is required.
Stallions with acquired inguinal/scrotal hernias are Clinical presentation
treated as emergency surgical colic cases. In affected The history of an affected stallion may include
animals the intestines quickly become severely com- scrotal trauma, infection, laceration or orchitis/
promised, requiring resection and anastomosis epididymitis. Palpation of the scrotum reveals
(Figs. 2.158, 2.159). The testis on the affected side single or multiple firm nodules of variable size
of the hernia is often devitalised due to compression in the region of the head, body or tail of the epi-
of the spermatic cord by the herniated intestine. didymis. Sperm granulomas can cause complete
Unilateral castration is required in these cases. The obstruction of the epididymal lumen, resulting in
inguinal rings are sutured closed to prevent recurrence. azoospermia.

Prognosis Differential diagnosis
Acquired inguinal/scrotal hernias carry a guarded to Neoplasia; epididymal cysts.
poor prognosis unless diagnosed and treated rapidly,
due to rapid devitalisation of intestines and testis. Diagnosis
Diagnosis is based on history, clinical signs, ultraso-
SPERM GRANULOMA nography (Fig. 2.160) and biopsy.

Definition/overview Management
Granulomatous inflammatory reaction occurring Unilateral castration is indicated if sperm
secondary to trauma or infection results in accu- granuloma is confined to one testicle. There is no
mulation of cells into variably sized masses in the known treatment to resolve sperm granulomas.
epididymis. Sperm granulomas are relatively rare in Complete obstructions do not generally change
stallions compared with other species such as rams. with time.

2.158 2.159

Figs. 2.158, 2.159 Same colt as in 2.157 Note the enlarged vaginal sac as it is removed from an inguinal
incision (2.158). An incision through the parietal vaginal tunic revealed a small loop of jejunum that had been
trapped and strangulated through the inguinal canal in the vaginal sac. This was manipulated back into the
abdomen and resected via a separate midline laparotomy incision (2.159). The colt was castrated and the
superficial inguinal ring closed by interrupted sutures.