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Internal Bowel Herniation, Incarceration, Strangulation, Entrapement in Horses

Internal equine bowel herniation can be caused by: a rent in the omentum or the mesentery; the nephrosplenic ligament; the epiploic foramen; the gastrosplenic ligament; the lateral ligament of the bladder; the broad ligament; a congenital defect or acquired tear in a normal ligament; or a vaginal tear. Strangulation by lipomas hanging from a stalk in the abdominal cavity (pedunculated lipoma) and Meckel's diverticulum have also been described.

Additional information

Pendunculated lipoma strangulation is the single most frequent cause of small intestinal strangulation in the University of Liverpool Equine Hospital. It is seen most often in older horses (greater than 15 years) and in ponies and cob type horses. Thoroughbreds and Arabs are less commonly affected.
A lipoma is a fatty lump on a stalk that hangs from the mesentery of the gut (pictured above). It causes strangulation by wrapping itself around a loop of intestine and pulling into a tight knot. This obstructs the flow of food material through the gut and also blocks blood supply to the intestine (strangulation) (pictured under) causing death of the intestine.

The strangulated intestine must be removed (resected) and the healthy ends re-joined. Pictured below is a loop of stangulated small intestine (black in colour) with strangulated lipoma (cream coloured mass mid-picture) prior to resection. This type of colic must be treated surgically. If surgery is not performed, the horse or pony will die. Lipomas can also cause colic by obstructing small intestine without affecting blood supply but this is far less common. Horses with this type of problem tend to have intermittent colic episodes with periods of normal gut function between.

The epiploic foramen is a narrow opening within the abdomen (pictured above). Epiploic foramen entrapment (efe) is a severe form of colic that arises when part of the horses gut (usually the small intestine) enters the epiploic foramen and becomes stuck (entrapped). Affected horses usually show severe signs of pain and will die within hours if the entrapped intestine is not removed surgically. The amount of intestine entrapped can vary from a few centimetres to many feet (pictured above). Due to the fact that affected intestine often needs to be removed and it can take time to free trapped intestine, horses with this type of colic are less likely to survive following surgery compared to other forms of colic.

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