A Case Report of Ileosigmoid Knotting

Ileosigmoid knotting occurs when the ileum wraps around the base of an elongated sigmoid colon, thus producing two closed-loop obstructions, with the possibility of ischemia and necrosis of either the ileum or sigmoid colon. Because of low incidence of the disease and its rapid progression to bowel gangrene, the diagnosis of the disease occurs late for most patients. ISK is more common in adults, with peak of its occurrence in 4th decade of life. A 32 years male patient with sudden onset abdominal pain which lasted for 12 hours, was operated by provisional diagnosis of acute of abdomen. Exploratory laparatomy revealed torsion of ileum around the sigmoid colon along with the gangrene of both of them. Resection of small bowel, with primary anastomosis, sigmoidectomy with end colostomy plus Hartman pouch was performed. Finally colostomy closed after 6 months.