Ileosigmoid knot

Ileosigmoid knot is a rare but serious medical condition that occurs when the ileum, a part of the small intestine, wraps around the base of the sigmoid colon and the superior rectal artery, creating a knot. This condition is considered a surgical emergency due to the risk of bowel ischemia and gangrene.

Causes

The exact cause of an ileosigmoid knot is not well understood. However, it is believed to be more common in individuals with a long small intestine or a freely mobile small bowel mesentery. Other factors that may contribute to the development of an ileosigmoid knot include a high-fiber diet, which can lead to increased peristalsis and bowel distension, and the presence of a sigmoid volvulus.

Symptoms

The symptoms of an ileosigmoid knot can vary depending on the severity of the condition. Common symptoms include abdominal pain, vomiting, constipation, and abdominal distension. In severe cases, patients may present with signs of shock due to sepsis or bowel ischemia.

Diagnosis

Diagnosis of an ileosigmoid knot can be challenging due to its rarity and the nonspecific nature of the symptoms. Imaging studies, such as a computed tomography (CT) scan, can be helpful in making the diagnosis. In some cases, the diagnosis is only made during surgery.

Treatment

The treatment for an ileosigmoid knot is surgical intervention. The surgery involves untwisting the knot and assessing the viability of the bowel. If the bowel is viable, it is returned to the abdominal cavity. If it is not, the affected portion of the bowel is removed, a procedure known as a bowel resection.

Prognosis

The prognosis for an ileosigmoid knot is generally poor due to the high risk of bowel ischemia and gangrene. Early diagnosis and treatment can improve the prognosis.

See also

• Small intestine
• Sigmoid colon
• Superior rectal artery
• Bowel ischemia
• Gangrene

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