Case Study - Pedunculated Lipoma


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  • Case Study - Pedunculated Lipoma

    1. 1. Case Study 1This is the story of Handsome...
    2. 2. Handsome“Handsome” is a 21 year old Thoroughbred and belovedlesson horse at Crescendo Farm in Beaverton.Handsome was lucky to survive a serious colic episodebecause his caretakers recognized and responded to thesituation immediately.
    3. 3. Something was wrong...Handsome ate his breakfast norma"y but was quieterthan normal when tacked up.When his rider went to get on, Handsome attempted toro".His rider removed the tack and Handsome continued totry to ro".He then began restlessly walking and kicking at this be"y.
    4. 4. The vet arrives...Handsome’s caretaker ca"ed ColumbiaEquine immediately.When Dr. Clabaugh arrived she gaveBanamine (for pain) and sedation butHandsome remained dramatica"ypainful.On rectal palpation, Dr. Clabaughcould feel a distended loop of sma"intestine. This was confirmed with anabdominal ultrasound.
    5. 5. Off to surgery...Handsome was stabilized fortransport to OSU for surgery where acantaloupe sized intestinal lipoma(fat tumor) was found with it’s cordwrapped around the sma" intestine.As the blood supply to the sma"intestine was compromised, 20 feet ofdead intestine needed to be removedalong with the tumor.
    6. 6. Long recovery...Despite his age,Handsome recovered we"(om surgery.
    7. 7. Handsome back at home...Because of the loving andqualified staff atCrescendo Farm and therapid veterinary response(om Columbia Equine,Handsome was able to goback to the job that heloves.
    8. 8. What is a Pedunculated Lipoma? Pedunculated lipomas are benign tumors that most (equently arise (om the wa" of the sma" intestine and remain attached by a pedicle (stalk). Obstruction of intestine by a pedunculated lipoma is one of the more commonly encountered causes of colic requiring surgical management. Geldings and ponies are know to be at a greater risk of colic resulting (om pedunculated lipomas than are other horses.
    9. 9. How does the lipoma cause colic? Pedunculated lipomas cause strangulating obstructions when the pedicle wraps around the sma" intestines. The weight of the lipoma, the length of the pedicle and sufficient momentum resulting (om movement of the horse or intestinal motility contribute a"ows the lipoma to wrap around the intestines much like a tether ba" wraps around a pole. Sometimes the lipoma swings with the intestines and does not wrap around. Sometimes it wraps around and then quickly unwraps and sometimes it wraps so tight it does not let go. The resulting compression prevents the flow of ingesta, occludes the blood vessels and causes intense pain.
    10. 10. How do you treat a Strangulating Lipoma?Once the stalk is wrapped tightly around the intestines, surgery is required toremove the lipoma and its stalk.If the stalk was wrapped tightly enough to cut off blood supply to theintestines long enough, the dead intestines wi" need to be removed.Rapid diagnosis is critical to identify the source of colic before the intestinesare compromised.