Strangulation of the caecum by a pedunculated lipoma in a Rocky Mountain Horse gelding
Authors: G. Elane, Todd Holbrook, Marley E. Iredale, Gemma Cock, A. Biedrzycki
Journal: Equine Veterinary Education
Summary
# Editorial Summary A 19-year-old Rocky Mountain Horse gelding presented with acute colic caused by an unusually complex entrapment: a pedunculated lipoma originating from the jejunal mesentery had strangulated both the caecum and ileocaecal junction. Surgical exploration revealed complete caecal devitalisation necessitating euthanasia, but necropsy uncovered a second pedunculated lipoma on the transverse colon showing ischaemic changes to its pedicle, suggesting the two lipomas had become intertwined in a half-hitch configuration despite the first lipoma's pedicle appearing anatomically too short for such entrapment. This case is the first documented instance of caecal and ileal strangulation by a mesenteric lipoma in equine literature, expanding our understanding of how these common fatty growths can precipitate life-threatening intestinal compromise. For practitioners, the case highlights that pedunculated lipomas—whilst frequently encountered—warrant serious consideration in colic presentations, particularly given the non-specific clinical presentation and the potential for multiple lipomas to interact in ways that create atypical strangulation patterns. The findings underscore the importance of thorough surgical exploration and systematic necropsy evaluation, as the complete anatomical picture only emerged post-mortem and may inform future diagnostic approaches in suspected lipoma-related colic cases.
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Practical Takeaways
- •Pedunculated lipomas should be considered in the differential diagnosis for colic cases, particularly strangulation-type colics, even when the anatomical presentation is atypical
- •Multiple pedunculated lipomas may be present in a single horse, so thorough surgical exploration and careful assessment of all mesenteric structures is warranted
- •Early recognition and surgical intervention remain critical, though prognosis depends on extent of intestinal devitalisation; this case demonstrates that even successful surgical relief may not prevent fatal outcomes if ischaemic damage is severe
Key Findings
- •A pedunculated lipoma originating from the jejunal mesentery caused strangulation of the caecum and ileocaecal junction in a 19-year-old Rocky Mountain Horse gelding
- •Complete caecal devitalisation occurred, requiring euthanasia despite surgical relief of the incarceration
- •A second pedunculated lipoma was identified at necropsy on the transverse colon with ischaemic changes consistent with entwinement with the jejunal mesenteric pedicle
- •This is the first reported case of caecal and ileal incarceration and strangulation by a pedunculated lipoma in equines