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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
PubMed

Insights

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.
Keywords:
Gangrenous sigmoid colon and ileumHartmann’s procedureIleosigmoid knot

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