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The current hypothesis proposed for strangulation of small intestine by a pedunculated lipoma in horses involves movement of the lipoma around the small intestine until it loops through its own pedicle. This mechanism is difficult to demonstrate during surgical correction. The objective was to examine an alternative explanation for strangulation by...
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Context 1
... mechanisms have been proposed by Kopf for inguinal hernia incarceration, but may also apply to lipoma strangulation. At this stage, the weight of the intestine that passes into the opening will cause it to 'fall' through the loop, thereby 'cinching' the incarceration (Fig 4). In fact, until occlusion of the lumen is complete, the peristaltic wave forces contents into the incarcerated segment, thereby increasing its weight and ultimately causing the strangulation. ...
Citations
... Lipoma disease is a disease characterized by lumps containing layers of fat that gradually accumulate under the skin, where these lumps are located between the skin and the muscle layer [5]- [7] . This disease often appears on the neck, back, shoulders, arms and thighs. ...
Lipoma disease is a disease characterized by a lump filled with a layer of fat that gradually accumulates under the skin, where this lump is between the skin and the muscle layer. This disease often appears on the neck, back, shoulders, arms, and thighs. In general, fat lumps or lipomas can be said to have slow growth between the skin and muscle layers. People tend to just let the lumps happen to them and think they are just normal lumps, without carrying out further examinations. The queue to see a doctor for further examination is also a factor. Therefore, it is necessary to make efforts so that the public can obtain information and be able to diagnose lipoma early without having to visit a doctor. From the description above, it is the basis for building a system that can provide information on lipoma disease and diagnose lipoma disease early. The system to be built can produce an early diagnosis analysis based on symptoms that are felt like a doctor, this system is commonly called an expert system, to support accuracy in building an expert system a method is needed in the analysis of its completion. One of the methods to be used is Certainty Factor (CF). The CF method is a clinical parameter value given by MYCIN to indicate the level of trust. The php programming language and MySQL database can build a system for diagnosing lipoma disease using the Certainty Factor method. type of lipoma Lipo Sarcoma 42.24%, Spindle cell lipoma, 56.59%, Myxoid liposarcoma 51.36%, Hibernoma 32%, Intramuscular hemangioma 51.48%, Chondroid lipoma 51.48%, Atypical lipoma 24%. From these results it can be said that the greatest confidence value is the type of Spindle cell lipoma disease with a confidence value of 56.59%.
... The ileum may be involved in a simple obstruction of the ileocecal valve or, as often happens, in strangulating lesions. The reason for this is not clear, and only hypothetical explanations, such as that peristalsis draws it into the entrapment, have been provided [2,3]. In strangulating lesions, if the ileum is necrotic, there is no other choice than resection and anastomosis (either jejunocaecal or jejunoileal); in all other cases (simple obstruction or damaged but viable), it may be necessary to decide to resect the ileum and perform an incomplete ileocecal bypass or manage these conditions conservatively. ...
Background:
Incomplete ileocecal bypass can be performed in cases in which an ileal disfunction is suspected but resection of the diseased ileum is not necessary.
Objectives:
To describe the clinical findings, the surgical technique, and the outcome of 21 cases of colic with ileal pathologies that underwent an incomplete ileocecal bypass.
Methods:
Historical, clinical, and surgical features of cases diagnosed with pathologies involving the ileum or the ileocecal valve that underwent ileocecal anastomosis without ileal resection were retrieved. Clinical (heart rate, duration of symptoms, presence of reflux, age, weight at arrival) and surgical (surgical pathology, duration of surgery, type of anastomosis) data were retrieved and analysed. Data on short term survival and postoperative complications (colic, post-operative reflux, incisional infection, fever), length of hospital stay, and long term follow up were also obtained.
Results:
A total of 21 horses met the criteria; 13 horses had ileal impaction (one with muscular hypertrophy), 5 horses had epiploic foramen entrapment, and 3 horses had a pedunculated lipoma. An incomplete ileocecal bypass was performed with a two-layer hand-sewn side-to-side technique in 19 cases and with a stapled side-to-side technique in 2 cases. Short term survival was 95.2%. At 12-months follow up, all horses but two were alive, and 13 of the 14 sport horses returned to their previous level of activity. Long term survival was 90.47%. Conclusions Incomplete ileocecal bypass may represent a valid surgical technique in case of ileocecal valve disfunction when ileum resection is not necessary; this technique may represent an alternative to extensive manipulation without subsequent recurrence of ileal impaction.
A 19‐year‐old Rocky Mountain Horse gelding was presented for emergency evaluation of colic. A pedunculated lipoma was found to be strangulating the caecum and ileocaecal junction at surgery. Following the resolution of the incarceration, it was found that the pedicle originated on the jejunal mesentery, but the stalk did not appear long enough to have formed a half‐hitch around both the caecum and ileum. The horse was euthanised due to complete caecal devitalisation. A second pedunculated lipoma was identified at necropsy, located on the transverse colon with an area of ischaemia on the mesenteric pedicle (the abnormal stalk of tissue connecting the lipoma to the colonic mesentery), consistent with pressure from being entwined with the jejunal mesenteric pedicle. This report is the first to describe caecal and ileal incarceration and strangulation by a pedunculated lipoma in a horse.
An obese 17‐year‐old Shetland pony mare with a history of recurrent colic episodes was presented for investigation of colic signs of a few hours' duration associated with marked tachycardia. Transabdominal ultrasonography identified a large amount of multilobulated tissue that was hypoechoic to the adjacent retroperitoneal fat within the caudal and ventral abdomen; this could be seen extending dorsally into the mid‐abdomen between intestinal structures. At exploratory laparotomy, a lipoma at the mesenteric attachment of the mid‐jejunum (considered likely to have caused intermittent extraluminal compression) as well as excessively thick layers of fat in the mesentery of both small and large intestine (compatible with lipomatosis) were identified. The lipoma was removed. Post‐operative recovery was uneventful. A strict diet was enforced, resulting in marked weight loss over the 12‐week post‐surgery period. Follow‐up abdominal ultrasound examination identified a reduction in the thickness of the retroperitoneal fat layer and the abnormal multilobulated tissue. This is the first case report detailing the ultrasonographic findings in a case of extensive mesenteric lipomatosis in a pony and describing the ultrasonographic improvement following a weight loss programme.
