Equis ISSN 2398-2977

Abdomen: lipoma - pedunculated

Contributor(s): Prof Derek Knottenbelt, David Moll, Rachel Murray, Vetstream Ltd

Introduction

  • Frequent cause of strangulating intestinal obstruction in older horses.
  • Cause: lipoma attached to mesentery by (long) pedicle with potential to wrap tightly around loop of intestine occluding lumen and blood supply.
  • Signs: mild, intermittent   →   severe, acute colic depending on degree of occlusion. Frequently non-pathogenic.
  • Treatment: surgical resection.
  • Prognosis: good with early surgical intervention. Not necessarily worse nor more frequent in fat horses.
See Intestinal neoplasia: tumor types table.

Pathogenesis

Pathophysiology

  • Partial or complete strangulating pedunculated lipoma   →   congestion and edema of intestinal wall   →   hemorrhagic fluid collects in lumen and affected section of bowel loses mucosal integrity   →   bacteria and endotoxin penetrate bowel wall and enter peritoneal cavity   →   hypovolemia, endotoxemia and metabolic acidosis   →   circulatory collapse   →   death.

Timecourse

  • Partial occlusion can cause intermittent colic over days/weeks.
  • Untreated - death follows strangulation in 24-48 h.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Derwilghen D et al (2013) A giant nonstrangulating mesenteric lipoma as a cause of recurrent colic in a horse. Equine Vet Educ 25 (9), 451-455 VetMedResource.
  • Garcia-Seco E et al (2005) Prevalence and risk factors associated with outcome of surgical removal of pedunculated lipomas in horses: 102 cases (1987-2002). JAVMA 226 (9), 1529-1537 PubMed.
  • Jansson N (2000) Spontaneous correction of a nonstrangulating ileal obstruction caused by a pendunculated lipoma in a 14-year-old pony. Equine Vet Educ 12 (3), 147-149 VetMedResource.
  • Edwards G B & Proudman C J (1994) An analysis of 75 cases of intestinal obstruction caused by pedunculated lipomas. Equine Vet J 26 (1), 18-21 PubMed.


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