Abstract
Ileosigmoid knotting (ISK) is one of the rare causes of acute intestinal obstruction, which has a rapid course for forming gangrene. ISK is considered a variant of sigmoid volvulus, which otherwise is called compound volvulus. The difficulty in ISK diagnoses is owing to its rarity, uncommon presentation, and non-specific radiological findings. The physiological status of the patient and intraoperative findings are the key factors in deciding the operative procedure of choice. Herein the author describes a rare case of ISK in a 70-year-old man with gangrenous ileum and sigmoid colon, which were treated successfully with resection and double stoma.
Highlights
Ileosigmoid knotting (ISK) is a rare condition to encounter at an emergency doorstep, where the ileal loop twists around the sigmoid colon and its mesentery or the opposite way
Prompt diagnosis, and early surgical intervention are the key factors in deciding postoperative mortality and morbidity
It has been postulated that ISK is more commonly seen in redundant sigmoid colon with a narrow pedicle, ingestion of a high bulk diet in the presence of an empty small bowel, and a freely mobile small bowel with long mesentery
Summary
Ileosigmoid knotting (ISK) is a rare condition to encounter at an emergency doorstep, where the ileal loop twists around the sigmoid colon and its mesentery or the opposite way. It is more common in males, with a mean age of 40 years. A 70-year-old male presented to the surgical emergency with complaints of abdominal pain for three days. The gangrenous bowel loops were resected, and an end ileostomy and descending end colostomy were performed in view of late presentation, old age, bowel edema, and peritonitis.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
