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Ileosigmoid knot - A Surgeon's Nightmare
Sujit M Chakma1, Rahul L Singh2, Mahadev V Parmekar1
1Final year PGT, Regional Institute of Medical Sciences(RIMS) , Imphal, India .
Journal of Clinical and Diagnostic Research : JCDR
|February 20, 2014
Summary
Ileosigmoid knot, a rare form of compound volvulus, caused intestinal obstruction in a young male. Surgical resection and anastomosis were performed to treat the gangrenous ileum and sigmoid colon.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Ileosigmoid knot, a type of compound volvulus, is an uncommon cause of intestinal obstruction.
- This condition involves the twisting of the ileum around the sigmoid colon.
Purpose of the Study:
- To report a case of ileosigmoid knot in a 30-year-old male.
- To describe the clinical presentation, surgical findings, and management.
Main Methods:
- Case report of a 30-year-old male presenting with abdominal pain.
- Clinical examination revealed suprapubic tenderness and signs of peritonitis.
- Exploratory laparotomy was performed for diagnosis and treatment.
Main Results:
- The laparotomy revealed a gangrenous sigmoid colon and a distended, gangrenous ileum twisted around the sigmoid base.
- A significant volume of hemorrhagic fluid was present in the abdomen.
- Surgical intervention involved resection of the affected ileum and sigmoid colon.
Conclusions:
- Ileosigmoid knot is a rare but critical condition requiring prompt surgical intervention.
- Successful management involved resection of necrotic bowel segments and anastomosis.
- Hartmann's procedure was utilized in this case for definitive management.
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