Abstract
The ileosigmoid knot is a rare surgical emergency. It is an unusual type of bowel obstruction in which the ileum usually wraps around the base of the sigmoid colon and forms a pseudoknot. It is usually associated with difficult preoperative diagnosis and poor surgical outcome. To analyze the clinical presentations, operative findings, management, postoperative complications and outcome of patients with ileosigmoid knotting. A retrospective analysis of nine cases of ileosigmoid knotting over a 6-year period from July 2005 to May 2011. Ileosigmoid knotting was common in males in the fifth decade. Mean duration of symptoms prior to admission was 42.67 h. Both the ileum and the sigmoid colon were gangrenous in all the patients. Mortality was 22.22 %. The mean duration of hospital stay was 13.67 days. To conclude, ileosigmoid knotting, though a rare cause of intestinal obstruction, carries a significant risk of mortality. In our study, ileostomy along with colorectal anastomosis seemed to be a better and safer alternative than primary repair in the management of ileosigmoid knotting. Awareness of this condition among surgeons will help to reduce the morbidity and mortality associated with this unusual form of intestinal obstruction.
Similar content being viewed by others
References
Gibney EJ, Mock CN (1993) Ileosigmoid knotting. Dis Colon Rectum 36(9):855–857
Puthu D, Rajan N, Shenoy GM, Pai SU (1991) The ileosigmoid knot. Dis Colon Rectum 34(2):161–166
Raveenthiran V (2001) The ileosigmoid knot. New observations and changing trends. Dis Colon Rectum 44(8):1196–1200
Watson RK (1984) Ileosigmoid knot. J ROY Coll Surg Edinburgh 29:100–102
Dorai CRT (1988) Ileosigmoid knot—case report. Sing Med J 29:413–415
Kallio KE (1932) Intestinal knot formation. Acta Chirugica Scandinavica 70(Suppl):211–276
Shepherd JJ (1967) Ninety-two cases of ileosigmoid knotting in Uganda. Br J Surg 54:561–566
Alver O, Oren D, Tireli M, Kayabasi B, Akdemir D (1993) Ileosigmoid knotting in Turkey. Review of 68 cases. Dis Colon Rectum 36:1139–1147
Atamanalp SS (2009) Ileosigmoid knotting. Eurasian J Med 41:116–119
Vaez-Zadeh K, Dutz W (1970) Ileosigmoid knotting. Ann Surg 172(6):1027–1033
Machado NO (2009) Ileosigmoid knot: A case report and literature review of 280 cases. Ann Saudi Med 29(5):402–406
Lee SH, Park YH, Won YS (2000) The Ileosigmoid knot. CT findings. Am J Roetgenol 174:685–687
Atamanalp SS, Ozturk G, Aydinli B, Yildirgan MI, Basoglu M, Oren D et al (2009) A new classification for ileosigmoid knotting. Turk J Med Sci 39(4):541–544
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Banerjee, C., Mukhopadhyay, M., Roy, A. et al. The Unusual Volvulus : A Five Year Retrospective Analysis of Nine Cases. Indian J Surg 76, 100–103 (2014). https://doi.org/10.1007/s12262-012-0551-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-012-0551-3