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Ileosigmoid knotting.

S Selcuk Atamanalp1

  • 1Atatürk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey.

The Eurasian Journal of Medicine
|January 23, 2015
PubMed
Summary
This summary is machine-generated.

Ileosigmoid knotting (ISK) is a rare condition where the small intestine wraps around the sigmoid colon. Prompt surgical intervention is crucial for treating ISK, with outcomes varying based on gangrene presence.

Keywords:
IleumKnottingSigmoid colon

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Ileosigmoid knotting (ISK) involves the ileum wrapping around the sigmoid colon or vice versa.
  • It is more prevalent in regions with high sigmoid volvulus rates and commonly affects adult males.
  • The exact cause of ISK remains debated.

Purpose of the Study:

  • To review the clinical presentation, diagnostic challenges, and management strategies for ileosigmoid knotting.
  • To highlight the importance of prompt surgical intervention in ISK cases.
  • To analyze the mortality rates associated with gangrenous and non-gangrenous ISK.

Main Methods:

  • Review of clinical symptoms and physical examination findings.
  • Analysis of diagnostic imaging modalities including plain abdominal X-rays and CT scans.
  • Evaluation of surgical treatment approaches and outcomes.

Main Results:

  • Key symptoms include abdominal pain, distention, obstipation, and vomiting.
  • Radiographic findings show a dilated sigmoid colon and small intestinal air-fluid levels; CT reveals a twisted sigmoid colon and mesentery.
  • Preoperative diagnosis is challenging, necessitating emergency surgery.
  • Treatment varies from untying the knot to resection with anastomosis, depending on gangrene.

Conclusions:

  • Early diagnosis and emergency surgery are vital for managing ileosigmoid knotting.
  • Mortality rates are significantly higher in gangrenous ISK (20-100%) compared to non-gangrenous cases (6.8-8%).
  • Surgical strategy should be tailored to the presence or absence of bowel necrosis.