Ekehorn () and Faltin () in their studies classified the ileosigmoid knot according to bowel involved and arrangement of loops. The ileosigmoid knot (also known as compound volvulus) is a rare cause of intestinal obstruction [1]. The condition is initiated by loops of ileum wrapping around. he ileosigmoid knot (also known as compound volvulus) is a rare cause of intestinal obstruction [1]. The condition is initiated by loops of ileum wrapping.

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This page was last edited on 26 Octoberat ISK is an unusual entity in the West, but is comparatively common in certain African, Asian and Middle Eastern nations, known as ‘volvulus belt’.

Ileosigmoid knot: a case report and literature review of cases

Skip to search form Skip to main content. Table 1 Clinical presentations and symptomatology as noted by various authors. Review of 68 cases. The condition progresses rapidly to gangrene, so early diagnosis and operative treatment are vital. Salman World Journal of Surgery From This Paper Figures, tables, and topics from this paper.

CT scan reveals the classic whirl sign of volvulus created by the involved, twisted loops of ileosigmoie intestine and the mesocolon. He was in distress and was dehydrated. This is because the ileum tightly envelops the base of the sigmoid colon, defying any such attempt.

Ileosigmoid knot – Wikipedia

knoot Preoperative CT scan diagnosis and prompt treatment can lead to a good outcome. ISK is very rare in many parts of the world. Patient was on regular follow-up and his general condition improved after 3 months when he was planned for relaparotomy and ileorectal anastomosis was done. Timely intervention is needed as it is a closed loop obstruction and that rapidly progresses to peritonitis and gangrene.


In type III, the ileocecal segment acts as the active component, while in type IV undetermined type it is not possible to differentiate the two components from each other. These three features of the clinical picture of small bowel obstruction, radiographic evidence of predominately large bowel obstruction, and inability to insert a sigmoidoscope could possibly form a useful diagnostic triad. In the past, a Hartmann operation or a covering colostomy was advocated to avoid the risk of fecal leak from colonic anastomosis.

Ileosigmoidal Knotting in Children: Two cases of ileosigmoid knot: This is a surgical emergency that requires urgent resection of gangrenous bowel and untwisting of the volvulus. Alver, 68 49 Overall a rare entity, ileosigmoid knot is more common in Asia, Africa and the Middle East than in the West.

The ileosigmoid knot.

Purchase access Subscribe now. Avoiding a colostomy is always welcome as it reduces the morbidity and cost of health care. Pan African Medical Journal. Unfamiliarity and diagnostic difficulties have contributed to the high morbidity and mortality of this condition in the past. In type II, sigmoid colon is the active component wrapping itself around ileum.

There is medial deviation of the distal descending colon with a pointed medial border thick arrow. Abdominal radiograph reveals a large gas-filled loop of the bowel in the right mid and lower quadrants Click here to view. This condition ileosigmoiid common in east Africa, particularly among the young males of the Baganda tribe.

The direction of torsion is clockwise in By using this site, you agree to ileoslgmoid Terms of Use and Privacy Policy. Create a free personal account to access your subscriptions, sign up for alerts, and more. Nonetheless, it is important that they should at least raise the suspicion of ISK Fig.


Ileosigmoid knot: a case report and literature review of 280 cases

ISK can rapidly progress to gangrene of the ileum as well as of the sigmoid colon. This article has been cited ilrosigmoid other articles in PMC. In recent years, CT has been helpful in making a preoperative diagnosis. Radiographically, ISK is often mistaken for simple sigmoid volvulus.

Author information Copyright and License information Disclaimer. ISK is a rare yet life-threatening cause of acute intestinal obstruction. Kakar A, Bhatnagar BN.

Intraoperative photographs show a distended sigmoid colon solid arrow and gangrenous ileal loops dashed arrow wrapped around each other forming an ileosigmoid knot Click here to view. In summary, ISK is a rare cause of intestinal obstruction. The ileosigmoid knot is an uncommon but life-threatening cause of closed loop intestinal obstruction. Case of intestinal obstruction: Abdominal examination oleosigmoid diffuse abdominal distension, tenderness, and guarding.

CASE A year-old male patient with a history of chronic constipation was admitted with severe lower abdominal pain of hour duration.

Three factors are responsible for the ileosigmoid knot [ 3716 ]:. Abdominal examination revealed guarding and rebound tenderness without any audible bowel sounds.

In view of the history and the CT scan findings, a diagnosis of ileosigmoid knot with gangrene of the involved sigmoid colon and ileal loops was made. How to cite this URL: Patient presented with vomitings and obstipation. Prompt treatment is mandatory.