Pedunculated lipomas as a cause of intestinal obstruction in horses: 17 cases (1983-1990)

The medical records of 17 horses that were evaluated and treated because of colic caused by pedunculated lipomas between 1983 and 1990 were reviewed. The mean age of the horses was 16.6 +/- 3.9 years (range, 10 to 26 years), which was significantly greater than that of the population of horses evaluated because of colic (control population) during the same period. There were significantly more geldings (76.5%), compared with the control population. Nasogastric reflux ranged from 1 to 16 L in 8 horses and was not obtained in 9 horses. Abdominal palpation per rectum revealed small intestinal distention in 13 horses, displaced large colon in 7 horses, and large colon impaction in 2 horses. Peritoneal fluid was abnormal in 11 of 12 horses from which it was obtained successfully. One horse was euthanatized after unsuccessful medical treatment. Surgery was performed in 16 horses. Lipomas were blindly resected in 5 horses or exteriorized and resected in 6 horses. The method used to resect the lipoma was not recorded in 5 horses. The ileum and/or jejunum was strangulated in 15 horses, the small colon was strangulated in 1 horse, and the jejunum was obstructed in 1 horse. The length of intestine resected ranged from 0.15 to 7.2 m. Fourteen horses survived surgery, of which 11 were discharged from the hospital (short-term survival rate of 78.6%). Excluding 2 horses lost to follow-up evaluation, 6 of 12 horses that survived surgery were alive 2 to 56 months following surgery (long-term survival rate of 50%), and 9 of 15 horses died or were euthanatized (fatality rate of 60%).