Ileosigmoid knot: case report and CT findings

Hirano, Yasumitsu; Hara, Takuya; Horichi, Yasushi; Nozawa, Hiroshi; Nakada, Kouichi; Oyama, Kaeko; Hada, Masahiro; Takagi, Tadayuki; Hirano, Minoru; Kitagawa, Kiyotaka

doi:10.1007/s00261-005-0315-7

Cited by 29 publications

(17 citation statements)

References 5 publications

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“…Nonetheless, it is important that they should at least raise the suspicion of ISK. The findings in a CT scan suggestive of ISK include the whirl sign created by the twisted intestine and sigmoid mesocolon in ileosigmoid knot, medial deviation of the cecum, and descending colon 111314. In addition, others have noted radial distribution of the intestine and mesenteric vasculature and consider it to be helpful diagnostic information 11.…”

Section: Discussionmentioning

confidence: 99%

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Ileosigmoid Knot: A Case Report and Literature Review of 280 Cases

Machado

2009

Ann Saudi Med

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Ileosigmoid knotting, also known as compound volvulus or double volvulus, is a rare cause of intestinal obstruction. In this condition the ileum wraps around the base of the sigmoid colon and forms a knot. Ileosigmoid knotting is an unusual entity in the West, but is comparatively common in certain African, Asian and Middle Eastern nations. The condition is serious, generally progressing rapidly to gangrene. Awareness of the condition is essential for prompt diagnosis and optimal management. This report describes a case in a 60-year-old male and describes the management of this rare condition. An additional 280 recent cases in the English literature are reviewed as to etiopathogenesis, presentation, diagnostic modalities, surgical interventions and outcome.

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Section: Discussionmentioning

confidence: 99%

“…However, CT examination may not be possible in all patients as some could be in poor condition or because of nonavailability. Whenever possible, a CT examination could be useful in making a diagnosis in these otherwise difficult patients 111314…”

Section: Discussionmentioning

confidence: 99%

Ileosigmoid Knot: A Case Report and Literature Review of 280 Cases

Machado

2009

Ann Saudi Med

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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

Hegde

Ananthasivan

Rawat

et al. 2019

Journal of Gastrointestinal and Abdominal Radiology

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Ileosigmoid knot (ISK) is an unusual and serious condition that is known to pose a diagnostic dilemma due to overlapping features of acute closed-loop intestinal obstruction. Early diagnosis and intervention are of immense importance in this condition because they can prove life threatening with rapid progression to gangrene of both the ileum and sigmoid colon. We report a case of a 27-year-old man who presented 2 days post-appendicectomy procedure with acute abdominal pain, abdominal distention, and hypovolemic shock. Initial evaluation with ultrasonography (USG) and abdominal X-ray was performed, which revealed pleural effusion, ascites, and an ahaustral dilated large bowel loop in the right upper abdomen with convergence in the left lower abdomen. Further imaging with computed tomography revealed closed-loop obstruction of the sigmoid colon with beaked appearance of its afferent and efferent limbs in the pelvis. There was associated whirling or knotting of the ileum around the sigmoid pedicle along with features of mesenteric ischemia. Emergency laparotomy was performed, which revealed ISK with gangrene of the ileal and large bowel loops.

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“…Stretched and elongated superior mesenteric (along with inferior mesenteric) vascular structures converging toward the sigmoid colon also indicate the diagnosis. [9] A radial distribution of the intestine and mesenteric vascular structures on CT scan can also suggest the diagnosis. [10]…”

Section: Discussionmentioning

confidence: 99%

Ileosigmoid knot: A case report

Baheti

Patel

Hira

et al. 2011

Indian Journal of Radiology and Imaging

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The ileosigmoid knot is an uncommon but life-threatening cause of closed loop intestinal obstruction. Its treatment is different from a simple volvulus in that it has to be operated upon immediately. Preoperative CT scan diagnosis and prompt treatment can lead to a good outcome. Findings of simultaneous ileal and sigmoid ischemia with non-ischemic colon interposed in between should, in an appropriate clinical setting, indicate this condition. The presence of the whirl sign, medially deviated distal descending colon and cecum, and mesenteric vascular structures from the superior mesenteric vessels that converge toward the sigmoid colon on CT scan help clinch the diagnosis.

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Ileosigmoid knot: case report and CT findings

Cited by 29 publications

References 5 publications

Ileosigmoid Knot: A Case Report and Literature Review of 280 Cases

Ileosigmoid Knot: A Case Report and Literature Review of 280 Cases

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

Ileosigmoid knot: A case report

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