Ninety-two cases of ileosigmoid knotting in Uganda

The Unusual Volvulus : A Five Year Retrospective Analysis of Nine Cases

“…Kallio [6] recorded the first case in 1932, but the name was popularized by Sheperd [7] in 1967. ISK generally occurs in areas with a high incidence of sigmoid volvulus.…”

“…ISK generally occurs in areas with a high incidence of sigmoid volvulus. ISK is more common in African, Asian, Eastern, and northern European and South American countries, and also in Turkey [3,[7][8][9]. ISK is common in adult males and the peak incidence is in the 3rd to 5th decades.…”

“…Three factors are responsible for the ileosigmoid knot: a long small bowel mesentery and freely mobile small bowel, a long sigmoid colon on a narrow pedicle, and finally the ingestion of a high-bulk diet in the presence of an empty small bowel [2,7,8,11]. When a semifluid bulky meal progresses into the proximal jejunum, it increases the mobility of the intestine and the heavier segments of the proximal jejunum fall into the left lower quadrant.…”

Ileosigmoid knot: a case report and literature review of 280 cases

“…Further peristalsis forms an ileosigmoid knot with two closed loop obstruction, one in the small bowel and other in the sigmoid colon 2–6. Evidence for the mechanism is suggested by studies carried out on Bagandans in Uganda who eat once a day and Muslims who eat a single daily meal during the Ramzan fast 24. ISK is predominately seen in males (80.2%) with a mean age of 40 years (range, 4-90 years) (Table 1).…”

“…In 73.5% to 79.4% of the cases, gangrenous bowel was encountered, whereas in 20.6% to 26.5% both small and large bowel were assessed to be viable in surgery 24. In 52.9% to 60.3% cases, both the small intestine and sigmoid colon were gangrenous 2489.…”