The ileosigmoid knot

Abstract

Correct preoperative diagnosis of ileosigmoid knot is possible when clinical, radiologic, and sigmoidoscopic features are considered together. Unraveling of the knot seems to be beneficial in ileosigmoid knot except when both components of the knot are frankly gangrenous. Primary anastomosis (ileoileal and/or colocolic) of resected gut seems to be a safe and better alternative in the management of ileosigmoid knot.

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

“…Appropriate antibiotic therapy is commenced early and continued after the operation. The usual antibiotic combination includes cephalosporins, aminoglycosides, and metranidazole 5712…”

“…Intraoperative colonic irrigation, followed by resection and primary anastomosis, is another alternative. Avoiding a colostomy is always welcome as it reduces the morbidity and cost of health care 12. In patients without sigmoid gangrene, mesosigmoidostomy is practiced by some to prevent recurrent ISK 5689…”

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

“…The diagnostic difficulty is partly caused by the unfamiliarity of this rare entity and the confusing and self-contradictory features of the disease. While clinical features such as vomiting suggest small bowel obstruction, the radiographic findings are that of colonic distension, which is uncommon in small bowel obstruction 3412. Radiographically, ISK is often mistaken for simple sigmoid volvulus.…”

“…The radiographic findings of ISK, which include a double loop of dilated sigmoid shadow and multiple air fluid levels in the small intestine, are sporadically described and are difficult to identify as such because of unfamiliarity 234812. Nonetheless, it is important that they should at least raise the suspicion of ISK.…”

“…Appropriate antibiotic therapy is commenced early and continued after the operation. The usual antibiotic combination includes cephalosporins, aminoglycosides, and metranidazole 5712…”