Ileosigmoid Knot

Abstract

Ileosigmoid knotting, also known as compound volvulus or double Volvulus, is a rare cause of acute intestinal obstruction. In this condition the ileum wraps around the base of the sigmoid colon and forms a knot. The condition is serious, generally progressing rapidly to gangrene of both ileum and sigmoid colon. Ileosigmoid knotting is an unusual entity in the West, but is comparatively common in certain African, Asian and Middle Eastern nations. Awareness of the condition is essential for prompt diagnosis and optimal management. This article will focus on the etiopathogenesis, presentation, diagnostic modalities, surgical interventions and outcome with review of articles and case reports published till date.

Ileosigmoid Knot—Unveiling the Diagnostic Dilemma with Radiologic Signs: A Case Report

“…features of double closed-loop obstruction with dilated sigmoid colon to the right and dilated small bowel loops in the left quadrant is an infrequent finding. 4,10,11 USG shows dilated bowel loops and other ancillary findings such as ascites and pleural effusion. It can aid in guided diagnostic ascitic tap that often reveals hemorrhagic fluid.…”

“…However, in most cases untwisting is difficult, and when bowel gangrene is demonstrated intraoperatively, resection of the ISK and the gangrenous segments is recommended followed by primary anastomosis. 10…”

Ileosigmoid knotting: a rare case report with review of literature

“…Convergence of superior mesenteric vein towards knot and medial pointing of caecum are other suggestive findings. Despite availability of various modern diagnostic tools in the present era, only 0–28% cases could be diagnosed preoperatively [ 3 , 10 ].…”

A new classification, treatment algorithm and prognosis‐estimating system for ileosigmoid knotting

“…Ileosigmoid knotting (ISK) is the wrapping of the ileum or sigmoid colon around the base of the other one, causing a double‐loop intestinal obstruction. It requires urgent and effective resuscitation followed by emergency surgery, and prognosis is poor . Although ISK is a rare disease worldwide, with fewer than 500 cases reported in the literature to date , it is relatively common in Turkey .…”