The Ileocaecal Knot

Menon, T. Bhaskara; Martin, Richard E.; Ramsay, Duncan; Archer, Stephen G.

doi:10.1111/j.1440-1673.2007.01814.x

Cited by 3 publications

(22 citation statements)

References 6 publications

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“…Operative finding in our patient was ileocecal knotting with gangrene of most of small intestine, cecum, and ascending colon. There were similar reports of ileocecal knotting by Tulsi Menon and colleagues in 2007 and by Arkaprovo Roy et al from Kolkata, India in 2011 7,12 …”

Section: Discussionsupporting

confidence: 61%

“…Certain CT features of ileocecal knotting were described by Menen T and colleagues. 7 In this patient in addition to ileum, most of jejunum was involved in wrapping around the mobile cecum and ascending colon and all these structures were found to be gangrenous. There was only 40 cm of viable jejunum remaining, and anastomosis between jejunum and transverse colon has to be done.…”

Section: Gebresellassiementioning

confidence: 72%

“…There were similar reports of ileocecal knotting by Tulsi Menon and colleagues in 2007 and by Arkaprovo Roy et al from Kolkata, India in 2011. 7,12 Intestinal obstruction by knotting is a very dangerous acute abdominal condition resulting in the development of gangrene in both loops of bowel involved in a short time. Our patient presented with a 2 days history of symptoms in a state of shock and had majority of small bowel, cecum, and ascending colon gangrenous.…”

Section: Gebresellassiementioning

confidence: 99%

“…It commonly presents with acute small bowel obstruction and needs urgent resuscitation and surgical intervention. 7 Occasionally, a subacute presentation which responds to conservative management has also been described. Surgical management often requires resection of gangrenous bowel and end to end anastomosis.…”

Section: Introductionmentioning

confidence: 99%

“…Ileocecal knotting occurs when a loop of ileum wraps around a mobile cecum and ascending colon. It commonly presents with acute small bowel obstruction and needs urgent resuscitation and surgical intervention 7 . Occasionally, a subacute presentation which responds to conservative management has also been described.…”

Section: Introductionmentioning

confidence: 99%

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Ileocecal knotting in a young man: A very rare and unique cause of intestinal obstruction

Gebresellassie

2020

Clinical Case Reports

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Section: Discussionsupporting

confidence: 61%

Section: Gebresellassiementioning

confidence: 72%

Section: Gebresellassiementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ileocecal knotting in a young man: A very rare and unique cause of intestinal obstruction

Gebresellassie

2020

Clinical Case Reports

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Ileocecal knotting as a rare cause of small bowel obstruction: a case report

Dallakoti,

Pant,

Pokhrel

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction: Ileocecal knot syndrome, a rare cause of small bowel obstruction, where the ileum wraps around the cecum, poses a significant challenge for preoperative diagnosis. Prompt intervention is crucial due to the risk of rapid bowel deterioration and increased mortality. Case presentation: A 45-year-old female presented with central abdominal pain associated with vomiting, abdominal distension, and obstipation. On examination, she was ill looking with hypotension, tachycardia with a feeble pulse, direct and rebound abdominal tenderness, and absent bowel sounds. Aggressive fluid resuscitation was done. Based on the clinical presentation and abdominal radiograph suggestive of intestinal obstruction, an emergency exploratory laparotomy was done which showed an ileocaecal knot and 130 cm of gangrenous ileum. Peritoneal lavage followed by resection of non-viable ileum with double barrel ileostomy was done. Discussion: Ileosigmoid, appendico-ileal, ileoileal, and ileocaecal knotting are the various types of intestinal knotting, with very few cases of ileocaecal knotting being reported. Intestinal knotting causes severe bowel obstruction, resulting in reduced mucosal perfusion, progressive ischemia, and peritonitis, leading to high mortality. X-ray findings of multiple air-fluid levels are non-specific, and for definitive diagnosis, laparotomy is required. Assessing bowel viability before definitive surgery is essential. Despite positive outcomes, extensive resection can lead to malabsorption and ileus, with potential risk for developing short bowel syndrome. Conclusion: Despite its rarity, the possibility of ileocecal knotting should be considered in cases of small bowel obstruction due to its potential for rapid deterioration. Prompt resuscitation followed by emergency laparotomy is necessary to prevent mortality.

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Ileocecal Knotting Causing Intestinal Obstruction on Early Postpartum Period: Case Report

Daba,

Belete,

Getachew

2023

IMCRJ

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Introduction Intestinal knotting syndromes are rare causes of mechanical bowel obstruction, ileo-sigmoid knotting being the most common type. Ileocecal knotting is the rarest type among knot syndromes and there are few case reports across the world. Case Presentation We present a case of ileocecal knotting in a postpartum patient with abdominal distention, vomiting and failure to pass feces and flatus. Plain abdominal radiograph revealed dilated small bowel loops with multiple air fluid levels. Exploratory laparotomy was performed with intra-operative finding of ileocecal knotting with viable bowel, mobile cecum and ascending colon and gangrenous tip of appendix. We untied the knot and performed an appendectomy. Due to intra-operative instability of the patient’s vital signs, right hemicolectomy was differed and cecum as well as ascending colon were fixed to right posterolateral abdominal wall. Clinical Discussion Ileocecal knotting is a very rare finding, and few case reports have been published. The intra-operative findings of the mobile cecum and ascending colon are consistent with previous reports and it is a predisposing factor for knot besides low BMI and young age of our patient. Surgical management is dictated by intra-operative conditions such as viability of the bowel, intra-operative stability of the patient, extent of resection and length of the remaining bowel. Surgical options include en bloc resection of knot with gangrenous bowel and end to end anastomosis or end ileostomy with closure of distal end. Conclusion Ileocecal knotting should be considered as a differential diagnosis for patients presenting with intestinal obstruction with unusual radiographic findings. Early diagnosis and prompt surgical intervention prevents bowel infarction and enhance the prognosis. Preoperative abdominal CT scan is helpful in such cases with unusual radiographic findings.

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The Ileocaecal Knot

Cited by 3 publications

References 6 publications

Ileocecal knotting in a young man: A very rare and unique cause of intestinal obstruction

Ileocecal knotting in a young man: A very rare and unique cause of intestinal obstruction

Ileocecal knotting as a rare cause of small bowel obstruction: a case report

Ileocecal Knotting Causing Intestinal Obstruction on Early Postpartum Period: Case Report

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