Hematoma no plexo pampiniforme associado à orquite em garanhão Crioulo

Background: The equine industry is growing in Brazil, specially the Crioulo breed, thus resulting in more investments and more diagnoses in clinical and reproductive diseases. Orchitis is related to subfertility, as a result of infectious agents, autoimmune diseases and traumatic injuries. After a traumatic injury, metabolic and vascular changes may occur, including testicular pathologies associated with blood flow changes. Reproductive tract injuries in stallions may result in impotentia coeundi and generandi, therefore requiring periodic monitoring and evaluation. This study aimed to report a case of hematoma in pampiniform plexus and orchitis in a Crioulo stallion, with differential diagnoses. Case: An equine, male, Crioulo horse, 6 years-old, was attended during reproductive season due to an increase in scrotal volume. During clinical evaluation all parameters were within reference values. During reproductive clinical evaluation it was observed enlarged, edema, heat and pain in the scrotum and testicules bilaterally. The testicle and spermatic cord presented discrete rotation, approximately 45o. In the dorsal board of right testicle, in the spermatic cord, it was noticed a structure firm to palpation, anecoic and avascularized at ultrasound exam. Blood samples were collected in EDTA tubes for hematologic evaluation. Seminal samples were collected with an artificial vagina an estrus mare. In EcoDoppler exam it was observed anechoic liquid in vaginal tunic, compatible with transudate, and an anechoic structure with irregular edges, avascularized, 2.7 cm width and 1.3 cm height. Hematologic analyses were all within reference limits. Seminal analyses were above acceptable limits proposed for stallions. The diagnosis was hematoma in the spermatic in association with orchids. Initial treatment was based on flunixin meglumine 1.1 mg/kg IV, dexametasone 0.01 mg/kg IV for 3 days and cold bath for 20 min. After 7 days, inflammatory local signs have declined. After 15 days, the stallion showed again edema in the scrotum and was treated with pentoxifylline 6 mg/kg PO for 30 days, dexamethasone 0.05 mg/kg IV for 3 days and cold bath. After 45 days the stallion was submitted to clinical evaluation with no inflammatory signs in the reproductive tract. After 83 days, the stallion had no swelling in the scrotum and testicular parenchyma had homogeneous echogenicity. Discussion: In stallions, an increase in scrotum volume with acute progress has several etiologies and differential diagnosis include: varicocele, inguinal hernia, neoplasm, inflammatory processes and spermatic cord torsion. In Crioulo breed, spermatic cord rotation is observed frequently by veterinary in the field, however there are few scientific reports. The partial or complete blood flow obstruction results in hemorrhagic and ischemic alterations in distal twisting structures, which may favor the occurrence of testicular degeneration and local hematomas. Ultrasound examination with Doppler was essential for morphological characterization of the lesion and performing differential diagnosis of neoplasia, varicocele, inguinal hernia. The diagnosis was based was based on clinical, hematologic, seminal and ultrasonography evaluation, which confirmed the presence of a hematoma in the pampiniform plexus and testicular inflammation. The treatment aimed to reduce inflammatory signs and stimulate blood flow. The stallion was regularly assessed and responded to therapy approach, with a favorable prognosis.