Ileosigmoid Knotting: A Case Series

Abstract

This case study describes two distinct cases of ileosigmoid knot (ISK), an uncommon surgical emergency that poses a serious risk of rapid necrosis caused by the small intestine twisting around the base of the sigmoid colon. The uniqueness of these cases lies in their rarity and the challenge they present in diagnosis due to the variability in clinical symptoms. The main symptoms observed included abdominal pain, distension, and vomiting, which are common in various gastrointestinal disorders, making the preoperative diagnosis of ISK particularly difficult. The primary diagnosis was confirmed only during surgery, highlighting the importance of exploratory procedures in such cases. To intraoperative findings, the therapeutic intervention comprised meticulously untwisting the knot, followed by excision of the necrotic segments and either anastomosis or stoma. The outcomes were favorable, with both patients showing signs of recovery post-surgery. The most important point to be gained from these cases is maintaining a high suspicion index for ISK among individuals presenting with acute bowel obstruction even in the absence of specific radiological signs. Early surgical intervention is crucial to prevent potentially fatal complications. This study contributes to the scientific literature by providing further insight into the diagnostic challenges and therapeutic strategies associated with ISK.