Ileosigmoid knotting--a case for primary anastomosis.

BACKGROUND

Resection of gangrenous/non-viable bowel followed by primary anastomoses is known to be a viable option for treatment of ileosigmoid knotting. We here report a case of ileosigmoid knot and examined the options for treatment.

METHOD: A case report of a patient with ileosigmoid knotting and discussion of relevant literature for surgical treatment.

RESULT: A 26 year old man presented to the accident and emergency unit with two weeks' history of fever and alternating diarrhea and constipation followed by features of intestinal obstruction and later, generalized peritonitis. Plain abdominal X-rays showed dilated loops of bowel and multiple air-fluid levels. The diagnosis of ileosigmoid knotting was missed preoperatively. At exploratory laparotomy, ileosigmoid knot was encountered with non-viable segments of the sigmoid colon and ileum. Resection of the non-viable bowel was carried out with primary anastomoses with good postoperative outcome.

CONCLUSION

Primary anastomoses after resection of gangrenous bowel is a safe surgical treatment option in ileosigmoid knotting.