The ileosigmoid knotting: a case report and review: Case Report

Khalid El Hattabi; Falousse Kabira; Lamiaa Mourafi; Abdelhak Ettaoussi; Abdessamad Majd; Khadija Kamal; Bouali Mounir; Abdelilah El bakouri

doi:10.58372/2835-6276.1242

Authors

Khalid El Hattabi CHU IBN ROCHD, Casablanca
Falousse Kabira CHU IBN ROCHD, Casablanca
Lamiaa Mourafi CHU IBN ROCHD, Casablanca
Abdelhak Ettaoussi CHU IBN ROCHD, Casablanca
Abdessamad Majd CHU IBN ROCHD, Casablanca
Khadija Kamal CHU IBN ROCHD, Casablanca
Bouali Mounir
Abdelilah El bakouri CHU IBN ROCHD, Casablanca

DOI:

https://doi.org/10.58372/2835-6276.1242

Keywords:

Ileosigmoid knot, abdominal CT scan, bowel obstruction, necrosis

Abstract

Introduction: Ileosigmoid knot or ileosigmoid knot (ISK), is an exceptional clinical entity, it is a surgical emergency characterized by strangulation of the small intestine forming a knot around the base of the sigmoid colon with risk of rapid necrosis of the small intestine and colon.

Case report: A 30-year-old patient with no previous history. Presented with occlusive syndrome and generalized abdominal pain. Clinical examination revealed a distended, tympanic abdomen with generalized abdominal tenderness.

The patient underwent a PSA, which revealed the presence of hydroaerosic levels. Abdominal CT scan showed a mechanical gallbladder bowel obstruction on mesenteric volvulus, probably without signs of digestive distress. Biological tests were normal, apart from a hyperleukocytosisof 23410/mm3.

Emergency surgery was performed and the diagnosis of ileo-sigmoid node was made intraoperatively.

Discussion: Through this case and a review of the literature, we will define the diagnostic, therapeutic and prognostic aspects of this rare clinical entity.

Conclusion: The ileo-sigmoid knot requires early preoperative diagnosis and prompt surgical management, to improve prognosis and reduce morbidity and mortality due to delayed diagnosis.

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