Add like
Add dislike
Add to saved papers

A rare occurrence of viability of both small and large bowel in ileosigmoid knotting: A case report.

INTRODUCTION: Ileosigmoid knot is an uncommon cause of acute intestinal obstruction where the ileum wraps around the base of a redundant sigmoid colon.

CASE PRESENTATION: We present an unusual case of a 45-year-old male patient who presented with signs and symptoms of intestinal obstruction. Exploratory laparotomy revealed an ileosigmoid knot. Both the small and large bowels were viable. The sigmoid colon was resected an end to end anastomosis was done. His post-operative period was uneventful.

DISCUSSION: Preoperative diagnosis of the condition is difficult. Diagnostic delays coupled with the infrequent occurrence of the condition often results in patients commonly presenting with gangrene of the ileum, sigmoid loop or both. There is considerable controversy regarding the optimal management of this rare condition. Management involves preoperative resuscitation, empirical antibiotics and prompt relief of the obstruction. The anatomical and pathological changes of the involved loops of bowel dictate the definitive surgical procedure. The vast majority of cases present with gangrenous loops of ileum, the sigmoid colon or both. To identify the presence of the ileum and sigmoid colon being viable on exploration is a rarity.

CONCLUSION: The management of a patient who has both viable loops of bowel on exploration is a contentious issue. Traditional teaching dictates that untying of the knot should be coupled with resection of the sigmoid colon to negate the risk of a recurrence. Some case reports suggest that resection may not be necessary as the risk of recurrence is believed to be low.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app