Ileosigmoid knotting in a young adult in Enugu, Nigeria - a case report.

A 25-year old male student who was seen in the emergency unit of our hospital with symptoms and signs of acute intestinal obstruction of 4 days duration is presented. Following resuscitation, an exploratory laparotomy revealed a long gangrenous jejunoileal segment with its base firmly knotted around the mesentery of the sigmoid colon which was also gangrenous. Resection and primary anastomosis of the small bowel was carried out. Hartmann's colostomy was also done following resection of the sigmoid colon. The features of this uncommon presentation of intestinal obstruction described in the literature as ileosigmoid knotting or compound volvolus are highlighted, with particular note that its recognition, rapid resuscitation and exploration will improve prognosis.