Evisceration in a horse submitted to orchiectomy: a case report

Abstract

This case report describes an evisceration of a segment of the small intestine in a male, 15-years-old Mangalarga Marchador horse, which was submitted to elective orchiectomy in a stud farm in Alegre, ES, Brazil. Following sedation and local anesthesia, the patient was submitted to the surgical procedure. Fifteen minutes after the end of surgery, hemorrhage from the region of the scrotum was observed, with tissue protruding from the surgical wound in the right scrotal sac. Visual exam revealed that it was a segment of the small intestine protruding from the inguinal ring and surgical wound. The patient was immediately submitted to TIVA (total intravenous anesthesia) and an emergency median laparotomy was performed to reduce the evisceration. The procedure was carried out with success and the right external inguinal ring was sutured. Six hours after the second procedure, the patient presented clinical signs of acute abdomen, and rectal palpation revealed a right inguinal hernia. It was decided to perform euthanasia of the animal as there was no referral large animal surgery center in the region. During necropsy, a segment of the jejunum insinuated in the right inguinal canal was observed, evidencing strangulation and a greenish appearance. Orchiectomy is a relatively simple technique to execute, which can be performed by the veterinary surgeon in the field. However, it presents elevated rates of complications, ranging from 20 to 38% of the cases, which are predominantly associated to surgical technique errors. Intestinal evisceration following orchiectomy is considered an emergency situation, requiring a fast and efficient therapeutic conduct. Its incidence is rare, occurring in between 0.2 and 2.6% of the cases of orchiectomy. It is believed that rectal palpation prior to orchiectomy could aid in the detection of a dilated internal inguinal ring, or any other alteration in this structure. Nevertheless, this practice is not performed pre-operatively in cases of orchiectomy in the equine species.