Ekehorn () and Faltin () in their studies classified the ileosigmoid knot according to bowel involved and arrangement of loops. The ileosigmoid knot (also known as compound volvulus) is a rare cause of intestinal obstruction [1]. The condition is initiated by loops of ileum wrapping around. he ileosigmoid knot (also known as compound volvulus) is a rare cause of intestinal obstruction [1]. The condition is initiated by loops of ileum wrapping.

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The empty loops of ileum and distal jejunum twist in a clockwise rotation around the base of a narrow sigmoid colon. Open in a separate window. ISK can rapidly progress to gangrene of the ipeosigmoid as well as of the sigmoid colon. The distal stump can be closed and end-to-side ileocecostomy can be performed as safer option. Clinical features suggestive of small bowel obstruction, 2.

The youngest reported patient and CT findings. Ileosigmoidal knotting, an unusual form of acute intestinal obstruction.

Management The initial management involves aggressive resuscitation with fluid and electrolytes and the correction of acid-base imbalance if any. Stretched superior mesenteric vessels converged lieosigmoid the whirl. Diagrammatic illustration of the ileosigmoid knot.

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Ileosigmoid Knot

Related articles Compound volvulus; ileosigmoid knot; intestinal obstruction. C A mnot caudal CT scan section shows efferent limbs of the sigmoid colon thick arrow and the ileal loop dotted arrow with appearances of a beak. Resected specimen total colon and distal ileum. The mortality figures are generally related to the duration of symptoms, the presence or absence of gangrene and the general status ileosigmiid the patient, including the presence of septicemic shock.


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CASE A year-old male patient with a history of chronic constipation was admitted with severe lower abdominal pain of hour duration. On immediate exploration after resuscitation, we found minimal haemorrhagic intraperitoneal fluid and gangrenous total colon, gangrenous distal ileal loop twisted around the base of the gangrenous sigmoid loop.

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The ileosigmoid knot.

B Caudal CT scan section shows the whirl sign within the circle created by the twisted mesentery and bowel branches arising ileosiymoid the superior mesenteric artery are present in the whirl. Abdomen was distended without visible peristalsis.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which jleosigmoid unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Nil, Conflict of Interest: The condition progresses rapidly to gangrene, so early diagnosis and operative treatment are vital.

A CT scan was planned, but could not be carried out for technical reasons. Figure 3 A, B. Diseases of the Colon and Rectum. Guidelines Upcoming Special Issues. In addition, a Meckel diverticulum with a small band was found at the base of the twist Figure 1.


Two cases of ileosigmoid knot: Case Report A year-old woman presented with a 3-day history of progressive abdominal pain associated with one episode of vomiting. CT scan plays a major role in the evaluation of any acute abdomen.

Privacy Policy Terms of Use. Two cases of Ileosigmoid knot: Ileosigmoid knotting in Turkey. None, Conflict of Interest: On examination, there was mild tenderness in the periumbilical and right lumbar region. The condition is serious, generally progressing rapidly to gangrene of both ileum and sigmoid colon. Ileosigmoid knotting, also known as compound volvulus or double Volvulus, is a rare cause of acute intestinal obstruction.

Get free access to newly published articles. The long arrow points to the knot while the short arrows point to the medial displacement of the descending colon and cecum Click here to view. After hemodynamic stabilization, immediate surgical intervention is the only viable option. Visit for more related articles at Journal of Surgery. Generalized peritonitis and sepsis is the main cause of poor outcome. Stretched and elongated superior mesenteric along with inferior mesenteric vascular structures converging toward the sigmoid colon also indicate the diagnosis.