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 . 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 . The condition is initiated by loops of ileum wrapping.
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Ileosigmoid knotting ISK is a rare cause of intestinal obstruction that rapidly progresses to gangrene of the ileum as well as the sigmoid colon. Outcome in 63 patients.
Atypical Presentation of Ileo-Sigmoid Knot: A Rare Case | OMICS International
The findings in a CT scan suggestive of ISK include the whirl sign created by the knog intestine and sigmoid mesocolon in ileosigmoid knot, medial deviation of the cecum, and descending colon. Timely intervention is needed as it is a closed loop obstruction and that rapidly progresses to peritonitis and gangrene.
In our case all three factors were present. Patient presented with vomitings and obstipation.
Ileosigmoid knot: A case report
USG revealed dilated fluid-filled small bowel loops and free fluid in pelvis. We are reporting a case of ileosigmoid knot in a year-old male, who presented with features of acute intestinal obstruction, peritonitis and hypovolemic shock. Except for a minor wound infection patient made an uneventful recovery and ileoslgmoid discharged after 10 days. In recent years preoperative diagnoses are being made more often, but it was a rarity in the past ileosjgmoid most cases.
Various surgical procedures have been conducted in these patients Table 3. Etiopathogenesis Three factors are responsible for the ileosigmoid knot [ 3716 ]: Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Author information Article notes Copyright and License information Disclaimer.
This article about a diseasedisorder, or medical condition is a stub. Showing of 7 references. Type III, the ileocecal segment active component wraps itself around the sigmoid colon passive component.
There is medial deviation of the distal descending colon with a pointed medial border thick arrow. Ileosigmoid knotting is an unusual entity in the West, but is comparatively common in certain African, Asian and Middle Eastern nations.
A new classification for ileosigmoid knotting.
A further caudal CT scan D shows fluid-filled ileal loops in the pelvis with thin non-enhancing walls solid arrow and free ileosigmokd present in the pelvic cavity dotted arrow. This article has been cited by other articles in PMC. In this condition the ileum wraps around the base of the sigmoid colon and forms a knot. Despite the critical condition, preoperative diagnosis is not easy. Knit cases of Ileosigmoid knot: Author information Copyright and License information Disclaimer.
Management of Ileosigmoid knotting.
Create a free personal account to access your subscriptions, sign up for alerts, and more. Ileosigmoid knotting in a ilesigmoid B Caudal CT scan section shows the whirl sign within the circle created by the twisted mesentery and bowel branches arising from the superior mesenteric artery are present in the whirl. Compound volvulus, ileosigmoid knot, intestinal obstruction. The direction of torsion is clockwise in Case Report Open Access.
The various surgical procedures undertaken in the past and present include:. Salman World Journal of Surgery Paradoxically, the incidence of bowel gangrene was In type II, the sigmoid colon active component wraps itself around a loop of ileum passive component in a clockwise or anticlockwise direction. This type of presentation we did not find to be reported in English literature even after DOIng through search, so a rare presentation. This was associated with progressive abdominal distension and vomiting.
Resection of the sigmoid colon is often advised in all instances even when viable. Nonetheless, it is important that they should at least raise the suspicion of ISK Fig.