Ileosigmoid knotting: A review of 923 cases.

Sabri Selcuk Atamanalp,Rifat Peksoz,Refik Selim Atamanalp,Esra Disci,Cansu Tatar Atamanalp

doi:10.12669/pjms.38.3.5320

Sabri Selcuk Atamanalp, Rifat Peksoz + Show 3 more

Open Access

https://doi.org/10.12669/pjms.38.3.5320

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Abstract

Objectives:Ileosigmoid knotting (ISK) is a rare intestinal obstruction form worldwide. The aim of this study was to investigate changing trends in ISK.Methods:The Web of Science and PubMed databases were electronically searched to find all publications to evaluate all epidemiological, etiological, clinical, laboratory, radiological, therapeutic, and prognostic factors in ISK.Results:Most of the cases were reported from Asian and African countries. Mean age was 43.9 years with a 79.9%/20.1% of male/female ratio. Main symptom period was 48.1 hours, while the most common clinical features were abdominal pain/tenderness (99.1%), distention (88.3%), and obstipation/constipation (58.8%). Abdominal X-ray radiography, computerized tomography (CT), and magnetic resonance imaging (MRI) were diagnostic in 8.2%, 96.2%, and 100.0%, respectively, while the total diagnostic accuracy rate was 20.8%. Bowels were gangrenous in 85.6% of the patients. Ileum resection was applied in 14.0% of the cases, while sigmoid colon resection in 7.6%, and both segment resection in 67.1%. The mortality rate was 22.7%, while the morbidity rate was also 22.7%.Conclusion:ISK is a rare disease, but it is still catastrophic despite its two-century recognised past. As an exception, diagnostic convenience arising from CT or MRI looks like the most important change over the last half-century.

Highlights

Ileosigmoid knotting (ISK) is the wrapping of the terminal ileum or sigmoid colon around the other structure causing a double-loop intestinal obstruction
ISK is a rare disease, but it is still catastrophic despite its two-century recognised past
The papers were utilized according to year, country, case number, age, gender, symptoms, signs, laboratory tests, radiological studies (X-ray, computerized tomography-CT, and magnetic resonance imaging-MRI), diagnostic accuracy, treatment, predisposing factors, and prognosis

Summary

Introduction

Ileosigmoid knotting (ISK) is the wrapping of the terminal ileum or sigmoid colon around the other structure causing a double-loop intestinal obstruction. ISK is a rare clinical entity worldwide, its incidence is relatively high in Asia, Africa, Middle East, South America, and Eastern and Northern Europa.[1] The incidence of ISK is relatively high in Eastern Anatolia, my practicing area.[2] My colleagues and I have 80 cases of experience with ISK, over 55 years from June 1966 to July 2021. This is one of the largest single-center. In light of our comprehensive experience, we wanted to evaluate all achievable ISK cases documented worldwide to investigate changing trends from past to present

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