Seke Manase Ephraim Kazuma,Bright Chirengendure,Luyando Simunyama,Kamwi Mundia,Royd Ngoma,Anadi Bulaya,
Review of Management of Ileosigmoid Knotting
International Journal of Surgical Case Reports
2021
2674-4171
http://dx.doi.org/10.31487/j.IJSCR.2021.01.02
https://www.sciencerepository.org/review-of-management-of-ileosigmoid-knotting_IJSCR-2021-1-102 
Abstract: Ileosigmoid knotting (ISK) is a rare type of intestinal obstruction caused by knotting of the mesentery of 
the ileum or sigmoid colon that rapidly progresses to gangrene with a high risk of mortality and high 
morbidity. The incidence of ISK is not well established, but it is higher in regions with high rates of sigmoid 
volvulus and in countries along the sigmoid belt. Clinical presentation is that of both small-bowel and large bowel obstruction and includes vomiting and nausea, abdominal pain, tenderness, and distention, with 
constipation. A contrast-enhanced computer tomography (CT) scan is the preferred modality for imaging. 
Management involves hemodynamic stabilisation with correction of shock using aggressive fluid 
resuscitation, electrolyte balance and commencement of antibiotics. Principles of surgery include resection 
of the knot, resection of the gangrenous bowel and establishing intestinal continuity. The outcome is 
generally complicated by peritonitis and sepsis that lead to mortality.Keywords: Ileosigmoid knotting, double or compound volvulus, intestinal obstruction