Open AccessIleosigmoid knotting: an unusual cause of acute intestinal obstruction with bowel gangrene
Author(s) -
Raj Kumar,
Pavan Kumar Shamanur Kenchappa,
Kiran Meena,
Brijesh Kumar Singh
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-226663
Subject(s) - medicine , gangrene , exploratory laparotomy , ileostomy , diverticulitis , sigmoid colon , laparotomy , bowel obstruction , ileal diseases , surgery , anastomosis , ileum , fistula , stoma (medicine) , shock (circulatory) , gastroenterology , rectum
Ileosigmoid knotting (ISK) is a rare cause of intestinal obstruction rapidly progressing to bowel gangrene. It is characterised by the wrapping of loops of ileum and sigmoid colon around each other. The condition often remains undiagnosed preoperatively; however, it can be suspected by the triad of small bowel obstruction, radiographic features suggestive of predominately large bowel obstruction and inability to deflate the intestine by a sigmoidoscope. We are reporting a case of 56-year-old man who presented with features of acute intestinal obstruction and compensated shock within 24 hours of onset of symptoms. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. In view of haemodynamic instability, end ileostomy was done after excising gangrenous segments. The patient improved and stoma closure and ileocolic anastomosis were done after 3 months in follow-up.