ABSTRACT
Up to 64% of all colic cases in adult horses and in foals involve the small intestine.1-5 The majority of small-intestinal colic cases (58% to 85%) are caused by strangulating lesions, compared with nonstrangulating obstructions (simple and functional),2-4,6,7 and 41% to 46% involve the ileum.7-9 The most common small-intestinal lesions in most reports are strangulation by lipoma, entrapment in the epiploic foramen, and small-intestinal volvulus, each accounting for more than 22% of all small-intestinal lesions.2-4,9-20
Strangulating Obstruction Pedunculated Lipoma Pedunculated lipoma is one of the most common causes of small-intestinal strangulation in horses,2-4,9-13,15,16,19 with a reported prevalence of up to 41% of surgical lesions of the small intestine.8 A pedunculated lipoma is a benign, smooth, fat tumor that is suspended by a mesenteric pedicle of variable length that wraps around intestine and its mesentery (Figure 36-1). It can be a solitary tumor or several can exist in the same horse, with 90% involving the small intestine.13 Mesenteric lipomas can cause simple, recurrent obstruction, but this is uncommon.10,21
Figure 36-1
A pedunculated lipoma strangulating a segment of small intestine.
