Open AccessIleosigmoid knot complicated by gastric and splenic mucormycosis: a lethal combination
Author(s) -
J. Islam,
S.R. Thomson,
Glynn Tudor,
Zafar Khan,
Monde Dennis Mjoli
Publication year - 2009
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.10.2008.1049
Subject(s) - medicine , laparotomy , mucormycosis , surgery , splenectomy , peritonitis , volvulus , jejunostomy , gastrectomy , general surgery , spleen , cancer , parenteral nutrition
Two very rare conditions, ileosigmoid knot and intra-abdominal mucormycosis, occurred sequentially in a middle-aged HIV positive male.At laparotomy for peritonitis, a gangrenous sigmoid volvulus with ileosigmoid knot was resected; 2 days later, colo-rectal continuity was restored, the distal ileum stapled and an end jejunostomy fashioned.At re-laparotomy on day 15, necrotic stomach and spleen required a total gastrectomy and splenectomy. At reoperation 2 days later, a bile leak at the oesophago-jejunostomy site was repaired. Despite this intervention he continued to deteriorate and died of multiple organ failure 4 days later.