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Case Reports
. 2024 Nov 26:49:92.
doi: 10.11604/pamj.2024.49.92.42322. eCollection 2024.

Twists and turns: unraveling the mystery of ileosigmoidal knotting, a rare and intriguing acute intestinal obstruction (a report of 3 cases)

Tariq Ahbala  1 , Youssef Ibneloualid  1 , Elhabib Lammat  1 , Khalid Rabbani  1 , Abdelouahed Louzi  1
Affiliations
Case Reports

Twists and turns: unraveling the mystery of ileosigmoidal knotting, a rare and intriguing acute intestinal obstruction (a report of 3 cases)

Tariq Ahbala et al. Pan Afr Med J. .

Abstract

Among the rare and complex causes of acute intestinal occlusion: volvulus due to the ileosigmoid node. The latter is secondary to the terminal ileum which will wrap around the base of the sigmoid colon and its meso, resulting in the formation of a node. Its natural evolution is the ischemia of the ileum and sigmoid, necessitating prompt emergency surgical intervention as the primary treatment approach. In this series, we present three cases from the Department of Digestive Surgery at Arrazi Hospital, Mohammed VI University Hospital in Marrakech, while reviewing the physiopathology, the clinical presentation of this rare entity, as well as the different therapeutic options of the ileosigmoid nodes. We report three cases in the Department of Digestive Surgery at Arrazi Hospital, Mohammed VI University Hospital in Marrakech, in which the diagnosis of ileosigmoid knotting was made by means of computed tomography (CT) scan data and confirmed intraoperatively. Through these 3 reported cases and in the light of data from the literature, we will discuss the different diagnostic, therapeutic, and prognostic aspects of this very rare type of volvulus.

Keywords: Acute intestinal occlusion; case report; compound volvulus; ileosigmoid knotting; sigmoid colon.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
computed tomography in sagittal reconstructions, with injection of contrast product showing the distention of a sigmoid loop with a whirl sign
Figure 2
Figure 2
intra-operative picture showing the Ileosigmoid knot with gangrenous ileum and sigmoid colon
Figure 3
Figure 3
intraoperative image showing ileal knot around the base of the sigmoid
Figure 4
Figure 4
intraoperative image after unwrapping the knot
Figure 5
Figure 5
a computed tomography scan showing a radial arrangement of the small bowel in the left lower quadrant with a transition zone, associated with a sign of whirlpool
Figure 6
Figure 6
image of an ileosigmoid knot
Figure 7
Figure 7
intraoperative view after the knot was unwrapped, sigmoid is viable
See this image and copyright information in PMC

References

    1. Hashimoto T, Yamaguchi J, Fujioka H, Okada H, Izawa K, Kanematsu T. Two cases of ileosigmoid knot: the youngest reported patient and CT findings. Hepatogastroenterology. 2004 May-Jun;51(57):771–3. - PubMed
    1. Miller BJ, Borrowdale RC. Ileosigmoid knotting: a case report and review. Aust N Z J Surg. 1992 May;62(5):402–4. - PubMed
    1. Atamanalp SS, Oren D, Basoglu M, Yildirgan MI, Balik AA, Polat KY, et al. Ileosigmoidal knotting: outcome in 63 patients. Dis Colon Rectum. 2004 Jun;47(6):906–10. - PubMed
    1. Fouquet V, Berrebi D, De Lagausie P, Azeinfish S, Chalard F, Peuchmaur M, et al. Ileosigmoid knotting in a child. The first case report in a French girl. Gastroenterol Clin Biol. 2006 Dec;30(12):1414–6. - PubMed
    1. Shepherd JJ. Ninety-two cases of ileosigmoid knotting in Uganda. Br J Surg. 1967;54(6):561–566. - PubMed

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