Abstract
Ileosigmoid knotting (ISK) is the wrapping of ileum and sigmoid colon around each other. The purpose is to evaluate the changes in incidence, treatment, and outcomes over several decades to the present. The clinical records of 78 patients over the last 50 years were reviewed retrospectively until June 1986, and prospectively thereafter, and the results of the first and last 25 years were compared. The incidence of ISK decreased during the reviewed 50-year period (p 0.05 for each), the typical symptomatic period shortened (p 0.05), but the preoperative diagnostic accuracy rate increased (p 0.05 for each). The predominant surgical treatment was modified, as resection with primary anastomosis generally took the place of resection with stoma for both ileum (p 0.05 for each), though the average hospitalization period shortened (p < 0.05). As a result, over time, we found a decrease in the incidence of ISK as well as some changes in the diagnostic and therapeutic strategies, although the clinical features and prognosis did not change.
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