An 8-year-old Thoroughbred mare presented to Cornell Equine and Farm Animal Hospital for an acute onset of colic. At admission, the patient was distressed, tachycardic, and dehydrated. She was refractory to pain control. Rectal examination revealed distended loops of small intestine and abdominal ultrasound revealed thickened small intestines. The patient was brought to surgery for an exploratory celiotomy. At surgery, an epiploic foramen entrapment was diagnosed and 3 meters of compromised jejunum were-resected. The patient received antibiotics, plasma, pain medication, prokinetic agents, and antiendotoxic agents postoperatively. She began to colic again 24 hours postoperatively. The colic did not resolve, and at 60 hours postoperatively a repeat celiotomy was elected. An obstructing mesenteric hematoma was discovered and removed. The patient steadily improved after her second surgery. She developed an incisional infection which was subsequently treated. The patient was discharged from the hospital 17 days after her second surgery.