Ultrasonographic features of pedunculated lipomas in two horses

Abstract

Summary Small intestine strangulation by pedunculated lipomas is a common cause of acute colic in horses. However, diagnosis of this condition prior to surgery may be difficult due to the poor specificity of the clinical signs. We describe the ultrasonographic findings of 2 horses presented for acute colic with a diagnosis of strangulating lipoma confirmed in surgery. Lipomas were identified as rounded and well‐defined, homogeneous hyperechoic structures, surrounded by distended small intestine loops and peritoneal fluid. Ultrasonographic identification of lipomas should be attempted during an abdominal scan, especially in horses with evidence of small intestinal ileus and/or obstruction.

Ultrasonographic identification of mesenteric lipomatosis in a Shetland mare with recurrent colic episodes

“…Similar findings have been reported in a limited number of published reports of abdominal lipomatosis in people (Furquim et al, 2009). Lipoma identification by ultrasound examination in symptomatic or asymptomatic patients is however described, both in people, affecting various organs (Bruneton et al, 1987; Lau & Thoeni, 2005; Liang et al, 2019; Puvaneswary et al, 2000; Skaane & Sandbaek, 1990), and in horses (Manso‐Díaz et al, 2018).…”

“…Ultrasonographic identification of intra-abdominal lipomas is complicated because they are often located deep within the abdomen and obscured by overlying gas-filled viscera. However, in a small number of cases, lipomas have been identified by abdominal ultrasonography prior to surgery (Manso-Díaz et al, 2018). Lipomas were identified by these authors as rounded and well-defined, homogeneous hyperechoic structures, surrounded by distended small intestine loops and peritoneal fluid.…”

Ultrasound examination of the equine acute abdomen

“…For example, thickened and amotile small intestinal loops, mainly in the cranial portion of the right abdomen, have occasionally been seen in cases of entrapment in the epiploic foramen. In elderly horses, small intestinal strangulation by a pedunculated lipoma should be considered as one of the main differential diagnoses (Fig 4d); however, lipomas can rarely be identified by ultrasound, and so confirmation that it is the cause of the clinical signs is not possible (Manso‐Díaz and others 2018).…”

Use of transabdominal ultrasonography in the acute abdomen: Has it really revolutionised our colic work‐ups?

“…; Manso‐Díaz et al . ), and articles analysing the accuracy of ultrasonography in the colic patient (Beccati et al . ; Naylor ; Cribb and Arroyo ).…”

“…), pedunculated lipomas (Manso‐Díaz et al . ), and described in this issue, the visualisation of a small intestine adenomatous polyp causing intestinal obstruction (Younkin et al . ).…”