Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jan 5:38:8.
doi: 10.11604/pamj.2021.38.8.27407. eCollection 2021.

Ileosigmoid knot in a patient with Down syndrome: a unique surgical emergency

Said Boussaidane  1 , Abderrahim Samlali  1 , Asma Hamri  1 , Youssef Narjis  1 , Benomar Ridouan Benelkhaiat  1
Affiliations
Case Reports

Ileosigmoid knot in a patient with Down syndrome: a unique surgical emergency

Said Boussaidane et al. Pan Afr Med J. .

Abstract

The ileosigmoid knot (ISK) or double ileosigmoid volvulus is a wrapping of the small intestine around the base of the sigmoid colon. We report an unusual case in the digestive surgery department of the Ibn Tofail Hospital of CHU Mohammed VI Marrakech of a 28-year-old man with Down's syndrome who presented with symptoms and signs of intestinal obstruction. Abdominal CT scan revealed a whirl sing and significant distension of the sigmoid loop. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. The surgical procedure was a necrotic digestive segments resection, with a double-barrelled ileostomy and a Hartmann procedure. One month afterwards, the patient was operated on to reestablish of the continuity. Through this observation and a review of the literature we define the diagnostic, therapeutic and prognosis aspects of this rare clinical entity.

Keywords: Down syndrome; Ileosigmoid knot; bowel obstruction; case report; necrosis; volvulus.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
the abdominal CT scan revealed a whirl sing and significant distension of the sigmoid loop, measuring 12 cm in diameter with parietal thinning
Figure 2
Figure 2
intraoperative view of the ileal node (arrow) around the base of the sigmoid, with necrosis of the twisted segments
Figure 3
Figure 3
intraoperative view showing digestive necrosis after knot detorsion
See this image and copyright information in PMC

Comment in

References

    1. Mungazi SG, Mutseyekwa B, Sachikonye M. A rare occurrence of viability of both small and large bowel in ileosigmoid knotting: a case report. Int J Surg Case Rep. 2018;49:1–3. - PMC - PubMed
    1. Varoquaux A, Ananian P, Richa H, Chagnaud C, Le Treut YP. Ileosigmoid knot is an unusual and severe cause of bifocal bowel strangulation. Gastroenterol Clin Biol. 2007;31(11):975–977. - PubMed
    1. Bensardi F, Elhattabi K, Fadil A, Benissa N, Lefriyekh R, Khaiz D, et al. Ileosigmoid knot: report of 2 cases. Pan African Medical Journal. 2012;11:43. - PMC - PubMed
    1. Atamanalp SS. Ileosigmoid knotting: one of the largest single-center series. Pak J Med Sci. 2018;34(3):671–675. - PMC - PubMed
    1. Bermudez BEBV, de Oliveira CM, de Lima Cat MN, Magdalena NIR, Celli A. Gastrointestinal disorders in Down syndrome. Am J Med Genet A. 2019;179(8):1426–1431. - PubMed

Publication types

LinkOut - more resources