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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The ileosigmoiv was resuscitated with IV fluids and ileosiymoid on IV cefuroxime and metronidazole and was taken up for laparotomy 4 hours after admission for suspected ISK based on both the small gut and sigmoid colon obstructive features on plain x-ray of the abdomen. 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.

With a provisional diagnosis of acute large bowel obstruction and peritonitis, we proceeded for emergency exploratory laparotomy. Patient presented with vomitings and obstipation. Further peristalsis forms an ileosigmoid knot with two closed loop obstruction, one in the small bowel and other in the sigmoid colon.

Ileosigmoid knot – Wikipedia

B Caudal CT scan section shows the whirl sign within the circle created by the twisted mesentery and bowel branches arising from the superior mesenteric artery are present in the whirl.

Although the mechanism by which an ileosigmoid knot develops is still speculative, it is generally accepted that certain anatomical predisposing factors are present, including a hypermobile small intestine with an elongated mesentery and a redundant sigmoid colon with a long mesocolon and a short attachment at the base of the mesentery.


Resection with primary anastomosis is advisable. Ann Jose ankara escort. Sign in to save your search Sign in to your personal account.

She had no other concurrent disease and no significant past medical or surgical history.

Ileosigmoid knot: A case report

A further caudal CT scan D shows fluid-filled ileal loops in the pelvis with thin non-enhancing walls solid arrow and free fluid present in the pelvic cavity dotted arrow. Recurrent volvulus or repeat knotting due to redundancy of the loop may cause gangrene after surgery. The anatomical and oleosigmoid changes dictate the operative procedure. Stretched superior mesenteric vessels converged toward the whirl.

The ileosigmoid knot.

Ileosigmoid knotting ISK is a rare cause of intestinal obstruction that rapidly progresses to gangrene of the ileum as well as the sigmoid colon. ISK has been categorized into three types. Create a free personal account to make a comment, download free article PDFs, sign up for ileosiigmoid and more.

Showing of 7 references. The direction of torsion is clockwise in A new classification for ileosigmoid knotting.

Parker is credited with having described the first patient with ISK in Besides the above anatomic prerequisites, the literature reveals the evidence of other secondary causative factors including late pregnancy, transmesenteric herniation, Meckel diverticulitis with a band, ileocecal intussusceptions, and floating cecum Table 2. Surgical Principles to Follow If both loops are viable, the knot may be undone by sigmoid enterotomy and traction of the nkot loop may be performed.


Routine investigations were normal apart from leukocytosis total count: Two cases of Ileosigmoid ileosigmoir Radiographically, ISK is often mistaken for simple sigmoid volvulus. Nil, Conflict of Interest: 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.

There is medial deviation ileosigmodi the distal descending colon with a pointed medial border thick arrow. A year-old male patient with a history of chronic constipation was admitted with severe lower abdominal pain of hour duration.

While ISK is predominately reported in certain African, Asian, and Middle-East nations, it is a rare occurrence in the white population [ 5101113 ]. The diagnostic difficulty is partly caused by the unfamiliarity of this rare entity and the confusing and self-contradictory features of the disease. It is uncommon to see cases presenting with total gangrenous colon and distal ileum which is an atypical presentation in our case and till now not reported in literature.

Ileosigmoid knot: A case report Baheti AD, Patel D, Hira P, Babu D – Indian J Radiol Imaging

Ileosigmoid knotting Lnot is a rare cause of intestinal obstruction that rapidly progresses to gangrene of the ileum as well as the sigmoid colon. Kakar A, Bhatnagar BN. Ninety two cases of Ileosigmoid knotting in Uganda.