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Tierarztl Prax Ausg G Grosstiere Nutztiere 2019; 47(01): 55-59
DOI: 10.1055/a-0825-7296
Kasuistik
© Georg Thieme Verlag KG Stuttgart · New York

Intramurales Lipom im Jejunum als Ursache für eine Invagination bei einer jungen Araberstute

Intramural jejunal lipoma in the small intestine of a young Arabian horse causing invagination of the jejunum
Aleksandar Vidović
1   Pferdeklinik St. Georg, Trier
,
Dorothea Jansen
1   Pferdeklinik St. Georg, Trier
,
Kathrin Hermeyer
2   IDEXX Vet Med Labor, Ludwigsburg
› Author Affiliations
Further Information

Publication History

06/07/2018

08/15/2018

Publication Date:
26 February 2019 (online)

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Zusammenfassung

Eine 2-jährige Araberstute wurde mit schweren Koliksymptomen vorgestellt. Die explorative Laparotomie ergab eine Jejunuminvagination verursacht durch eine intramurale Umfangsvermehrung. Das betroffene Jejunumsegment wurde reseziert und eine End-zu-End Anastomose geschaffen. Am eröffneten Resektat zeigte sich eine noduläre Umfangsvermehrung innerhalb der Submukosa am Anfang des Intussuszeptums mit einem Durchmesser von 10 cm, die zu einer beinahe vollständigen Obliteration des intestinalen Lumens führte. Zusätzlich war eine ausgeprägte Hyperämie der Jejunummukosa erkennbar. Bei der histopathologischen Untersuchung wurde in der Submukosa des Jejunums eine gut abgrenzbare Umfangsvermehrung bestehend aus gut differenzierten Adipozyten festgestellt und die Diagnose eines intramuralen Lipoms gestellt. Die Dünndarmmukosa zeigte leichte bis mittelschwere Anzeichen einer Kongestion. Ein Lipoma pendulans induziert bei älteren Pferden häufig eine Dünndarmstrangulation, die operativ behoben werden muss. Nach Kenntnis der Autoren wurde ein intramurales Lipom bisher nicht als Ursache einer Dünndarminvagination beschrieben. Die Stute erholte sich komplikationslos und zeigte auch 6 Monate nach der Operation keine weiteren Kolikanzeichen.

Abstract

A 2-year-old Arabian horse was presented with severe colic symptoms. During explorative laparotomy, a jejuno-jejunal invagination secondary to a submucosal intestinal mass was detected. The involved jejunal segment was surgically removed and an end-to-end anastomosis was created. Opening the specimen demonstrated the presence of a nodular mass on the head of the intussusceptum, measuring 10 cm in diameter, and almost completely obliterating the intestinal lumen. Additionally, a severe hyperemia of the jejunal mucosa was visible. Histological examination, which revealed a well-demarcated mass in the submucosa of the jejunum consisting of well-differentiated adipocytes, led to the diagnosis of an intramural lipoma. The small intestinal mucosa displayed mild to moderate signs of congestion. Pedunculated lipomas in the mesentery of horses causing intestinal volvulus and obstruction are a frequent cause of small-intestine strangulation in aged horses. To the authors’ knowledge, intramural intestinal lipomas to date have not been described in the horse. The mare recovered without complications and was free of colic symptoms after 6 months.

Schlüsselwörter

Pferd - Kolik - Dünndarm - Kolikchirurgie - Intussuszeption

Key words

Horse - colic - small intestine - colic surgery - intussusception
 

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