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Ileosigmoid knotting.

I H Mallick1, M C Winslet

  • 1University Department of Surgery, Royal Free & University College Medical School, London, UK.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|June 23, 2004
PubMed
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Ileosigmoid knotting is a rare cause of intestinal obstruction, often fatal if not diagnosed and treated promptly. Early surgical intervention and intensive care are crucial for reducing mortality and morbidity.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Emergency Medicine

Background:

  • Intestinal obstruction is a frequent surgical admission, with common causes often managed conservatively.
  • Rarer causes, such as ileosigmoid knotting, demand urgent diagnosis and surgical intervention to prevent strangulation and gangrene.
  • Increasing global travel and migration are leading to the emergence of ileosigmoid knotting in non-endemic regions.

Purpose of the Study:

  • To review the etiology, pathophysiology, clinical features, diagnostic methods, and surgical management of ileosigmoid knotting.
  • To consolidate information from English literature on this rare but life-threatening condition.
  • To highlight the importance of prompt diagnosis and aggressive management.

Main Methods:

  • Literature search of PubMed, ISIS, Embase, and CAS databases (1966-2004).

Related Experiment Videos

  • Keywords used included: ileosigmoid knotting, intestinal knotting, compound volvulus, and double volvulus.
  • Review of reference lists from identified articles.

    • Main Results:

    • Ileosigmoid knotting is associated with high morbidity and mortality.
    • Prompt surgical relief of obstruction is critical.
    • Aggressive resuscitation, appropriate antibiotics, intra-operative viability assessment, and intensive care are key management components.

    Conclusions:

    • Ileosigmoid knotting requires immediate surgical management to avoid catastrophic outcomes.
    • Effective treatment involves a multi-faceted approach including resuscitation, surgery, and postoperative care.
    • Early recognition and intervention significantly improve patient outcomes for this rare intestinal obstruction.