Ileosigmoid Knotting: Changing Trends Over 50 Years

Atamanalp, Sabri Selçuk; Korkut, Ercan; Karadeniz, Erdem; Aksungur, Nurhak

doi:10.1007/s12262-017-1636-9

Cited by 3 publications

(6 citation statements)

References 21 publications

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“…Mallick and Winslet, in their study, showed that septic shock with multiorgan failure was the commonest cause of mortality. 7,29 Similarly, multiorgan failure due to refractory septic shock accounts for 63.3% of mortalities in our study. According to a study done by Scot, age, duration of symptoms, and extent of gangrene were significant predictors of mortality.…”

Section: Multivariable Cox Regression Analysis For Survival and Surgi...supporting

confidence: 57%

Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low‐resource setup: A retrospective cohort study at Jimma University Medical Center

Bayleyegn,

Zelelew,

Sisay

2024

World j. surg.

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BackgroundBowel obstruction is a mechanical or functional blockade of intestinal contents from evacuation to the adjacent distal bowel or external environment. It poses significant morbidity and mortality in both high‐income and low‐to‐middle‐income countries. Ileosigmoid knotting is a special form of obstruction where the small bowel often ileum wraps around the sigmoid colon or vice versa. It is the severest form of bowel obstruction, involving both the small and large bowels in a compound manner. It is common where sigmoid volvulus is common and geographic areas with a bulky diet.MethodsAn institution‐based retrospective cohort study was employed among purposively selected 40 surgical patients with ileosigmoid knotting records from July 2020 to July 2023 at Jimma University Medical Center. To estimate and compare the survival probabilities, the Kaplan‐Meir method and log‐rank test were used. A Cox‐regression analysis was fitted to identify independent predictors of time to death.ResultsAmong a cohort of 40 patients followed for 347 person‐days at Jimma University Medical Center, 11 (27.5%) had died. The overall incidence rate of death was 3.2 (95% CI 1.8, 5.7) per 100 person‐days. In multivariable Cox‐regression analysis, age (AHR = 1.15; 95% CI: 1.04–1.28), shock at presentation (AHR = 30.50: 95% CI 1.25–742.54), comorbidities (AHR = 5.81; 95% CI 1.19–28.23), pulse rate intraoperatively (AHR = 1.19; 95% CI: 1.01–1.40), postoperative pulse rate (AHR = 1.07; 95% CI: 1.01–1.14) were independently associated with time to death.ConclusionThe incidence of death among surgical patients with ileosigmoid knotting was high and also had a shorter median survival time. Age, shock at presentation, comorbidities, pulse rate intraoperatively, and postoperative pulse rate were found to be statistically significant predictors of time to death and outcome among surgical patients with Ileosigmoid knotting.

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Section: Multivariable Cox Regression Analysis For Survival and Surgi...supporting

confidence: 57%

Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low‐resource setup: A retrospective cohort study at Jimma University Medical Center

Bayleyegn,

Zelelew,

Sisay

2024

World j. surg.

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“…Although ISK is rarely observed worldwide 1 , 2 , it is accepted as an endemic disease in Turkey, particularly in our region Eastern Anatolia. 5 - 7 As presented in our series, high altitude, high-fiber diet habits, male gender and advanced age are known as probable causes of an anatomical predisposition to ISK, namely, an elongated sigmoid colon with a narrow mesentery in addition to a hypermobile terminal ileum. 1 , 2 , 5 , 8 …”

Section: Discussionmentioning

confidence: 63%

“…The classical volvulus triad, abdominal pain/tenderness, distention, and obstipation, is observed in 27.3-100% of patients. 1 , 2 , 5 , 7 - 14 X-ray features, such as a dilated sigmoid colon with multiple intestinal air-fluid levels, most commonly indicate a sigmoid volvulus or a nonspecific intestinal obstruction. 1 , 2 , 5 , 8 , 9 CT and MRI findings, including a knot in the ileum and sigmoid mesenteries with a dilated sigmoid colon and multiple intestinal air-fluid levels, is highly diagnostic in greater than 90% of cases.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 As of 2018, less than 500 cases have been reported in the literature. 3 , 4 Interestingly, the incidence of ISK is relatively high in eastern Anatolia, 5 - 7 where our university clinic is located. Consequently, our ISK series is one of the largest single-center ISK series in the world according to the literature included major research databases, such as Web of Science 3 and PubMed.…”

Section: Introductionmentioning

confidence: 93%

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Ileosigmoid knotting: One of the largest single-center series

Atamanalp

2018

Pak J Med Sci

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Ileosigmoid knotting (ISK) is the wrapping of the ileum or sigmoid colon around the base of the other structure, causing a double-loop intestinal obstruction. The disease generally presents as an intestinal obstruction with volvulus triad, including abdominal pain/tenderness, distention, and obstipation. Abdominal X-ray findings are not pathognomonic, and computerized tomography (CT) and magnetic resonance imaging (MRI) are more useful in the diagnosis. A patient with ISK generally requires an emergency laparotomy following resuscitation. Based on the viability of the ileum and sigmoid colon, different resectional or non-resectional surgical techniques may be used. In this report, one of the largest single-center ISK series in the world, an eighty-case series, is concisely presented.

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“…Less than 500 cases have been stated in the literature as of 2018 [5] , [6] . It is interesting to note that the incidence of ISK is relatively high in eastern Anatolia [7] , [8] , [9] .…”

Section: Introductionmentioning

confidence: 99%

Ileosigmoid knotting: A case report of unique cause of acute abdomen in a Nepalese patient

Subedi

Gupta

Neupane

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance Ileosigmoid knotting is a surgical emergency. Common in Asian males, it is presented with signs and symptoms of diffuse peritonitis. Aggressive resuscitation with intravenous fluids and antibiotics followed by workup enable the patient hemodynamically stable. Explorative laparotomy followed by colo-colic anastomosis and double barrel ileostomy is curative. Case presentation A 32-year-old-male from Nepal with a chief complain of diffuse abdominal pain for a day and signs of peritonitis presented to Emergency room. After assessing and stabilizing the patient, explorative laparotomy was performed. Ileal and sigmoid resection followed by colo-colic anastomosis and double barrel ileostomy was done. On regular follow-up, he is in his usual state of health. Discussion The incidence of ileosigmoid knotting is reported to be about 1.6 cases per year. It is often misdiagnosed as non-specific intestinal obstruction which confers poor prognostic value to the patient. It should be identified promptly and intervened timely. Conclusion Ileosigmoid knotting is a rare but dangerous differential of acute abdomen not to be missed. Early assessment and quick decision making is the key to provide excellent prognosis to the patient in need, provided adequate surgical skills are demonstrated.

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Ileosigmoid Knotting: Changing Trends Over 50 Years

Cited by 3 publications

References 21 publications

Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low‐resource setup: A retrospective cohort study at Jimma University Medical Center

Evaluation of clinical profiles, surgical experience and outcomes of ileosigmoid knotting in low‐resource setup: A retrospective cohort study at Jimma University Medical Center

Ileosigmoid knotting: One of the largest single-center series

Ileosigmoid knotting: A case report of unique cause of acute abdomen in a Nepalese patient

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