The ileosigmoid knot
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The ileosigmoid knot (ISK) is a rare cause of intestinal obstruction. Unfamiliarity with the condition could have disastrous consequence at surgery. Over the past 20 years, we have encountered seven cases. Analyzing the data gathered from these, and on reviewing the literature, we found it possible to arrive at a preoperative diagnosis in two patients. Four patients were women, two of whom developed the obstruction in the postpartum period. One of the males was found to have an inflamed Meckel's diverticulum included in the knotting. The symptoms and the clinical findings were nonspecific. The characteristic x-ray findings of a double closed loop obstruction, was seen in only three patients. Resection of gangrenous bowel with anastomoses was feasible in four. Unlike in other series, primary anastomosis of the large gut was undertaken. There were two deaths early in the series. Guidelines to the management have been suggested.
Key wordsVolvulus Sigmoid diseases Ileosigmoid knot
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- 1.White A, Angor IB, Al-Hashimi HM, Wong J. Acute surgical problems in nontemperate zones. In: Dudley HA, ed. Hamilton Bailey's emergency surgery. 11th ed. Bristol: John Wright & Sons Ltd., 1986:702–3.Google Scholar
- 2.Ellis H. Volvulus of the small intestine and intestinal knotting. In: Intestinal obstruction. New York: Appleton-Century-Crofts, 1982:297–9.Google Scholar
- 6.Parker E. Case of intestinal obstruction. Sigmoid flexure strangulated by the ileum. Edinb Med Surg J 1845;64:306–8.Google Scholar
- 7.Kallio KE. Die Knotenbildungen des Darmes. Acta Chir Scand 1932;21(suppl.):1–276.Google Scholar
- 10.Shamblin JR. Volvulus of the sigmoid: with entrapment and strangulation of the small bowel. Southern Med J 1965;58:1279 passlm.Google Scholar