Ekehorn () and Faltin () in their studies classified the ileosigmoid knot according to bowel involved and arrangement of loops. The ileosigmoid knot (also known as compound volvulus) is a rare cause of intestinal obstruction [1]. The condition is initiated by loops of ileum wrapping around. he ileosigmoid knot (also known as compound volvulus) is a rare cause of intestinal obstruction [1]. The condition is initiated by loops of ileum wrapping.

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Table 2 Predisposing factors and pre-operative investigation done for diagnosis as by various authors.

C A more caudal CT scan section shows efferent limbs of the sigmoid colon thick arrow and the ileal loop dotted arrow with appearances of a beak. Intraoperative colonic irrigation, followed by resection and primary anastomosis, is another alternative.

Ileosigmoid knot: A case report

Primary anastomosis of the small bowel is preferable, but if the terminal ileum is gangrenous to within 10 cms of the ileocecal valve, an end-to-end anastomosis should not be attempted. Home Publications Conferences Register Contact.

Postoperative period was uneventful and the patient was discharged on tenth post-operative day. Ileosigmoid knot as such is a very rare cause of intestinal obstruction and a high degree of suspicion is needed in cases mimicking sigmoid volvulus.

Ileosigmoid Knot | JAMA Surgery | JAMA Network

Ileosigmoid knot as a cause of acute abdomen at 28 weeks of pregnancy: Parker [ 1 ] is credited with having described the first case of ISK. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more.


The findings in a CT scan suggestive of ISK include the whirl sign created by the twisted intestine and sigmoid mesocolon in ileosigmoid knot, medial deviation of the cecum, and descending colon. The direction of torsion is clockwise in USG revealed dilated ileosig,oid small bowel loops and ileosigmooid fluid in pelvis.

A further caudal CT scan D shows fluid-filled ileal loops in the pelvis with thin non-enhancing walls solid arrow and free fluid present in the pelvic cavity dotted arrow Click here to view.

Ileosigmoid knot

Turk J Med Sci. In summary, ISK is a rare cause of intestinal obstruction. With a provisional diagnosis of acute large bowel obstruction and peritonitis, we proceeded for emergency exploratory laparotomy. Abdominal radiograph reveals a large gas-filled loop of the bowel in the right mid and kot quadrants Click here to view. The postoperative course was uneventful and the patient was discharged a week after the surgery.

An additional recent cases in the English literature are reviewed as to etiopathogenesis, presentation, diagnostic modalities, surgical interventions and outcome. On immediate exploration after resuscitation, we found minimal haemorrhagic intraperitoneal fluid and gangrenous total colon, gangrenous distal ileal loop twisted around the base of the ileosigmoud sigmoid loop. ISK is a rare yet life-threatening cause ileosigmid acute intestinal obstruction. National Center for Biotechnology InformationU.


August 05, ; Accepted Date: Kakar A, Bhatnagar BN.

The ileosigmoid knot. – Semantic Scholar

Impact of CT on diagnosis and management of acute abdomen in patients initially treated without surgery. This article will focus on the etiopathogenesis, presentation, diagnostic modalities, surgical interventions and outcome ileosigmooid review of articles and case reports published till date.

In the recent years, contrast-enhanced computed tomography is emerging as a sensitive tool for ileosigmoiid diagnosis of ISK. Three factors are responsible for the ileosigmoid knot [ 3716 ]:. Author information Copyright and License information Disclaimer. The anatomical and pathological changes dictate the operative procedure.

It is uncommon to see cases presenting ileosigmoif total gangrenous colon and distal ileum which ileoigmoid an atypical presentation in our case and till now not reported in literature.

Two cases of ileosigmoid knot: Further peristalsis forms an ileosigmoid knot with two closed loop obstructions Fig. A long small bowel mesentery and a sigmoid colon on a narrow pedicle are necessary prerequisites, but the wide variation in incidence of ISK across the world seems to be related to dietary habits.