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IMPROVED OUTCOME IN A RARE VARIANT OF ILEOSIGMOID KNOTTING WITH EXTENSIVE BOWEL GANGRENE: A CASE REPORT

R. S. Mohil, P. Panwar, G. J. Singh, V. Kandwal, U. Jethwani, R. Bamal

Abstract


We report a rare variant (Type 2A) of ileosigmoid knotting presenting with features of peritonitis, and causing extensive small bowel gangrene with gangrene of sigmoid colon, leading to short bowel syndrome post operatively. The mortality rate reported in such cases is very high. These patients require combined oral and parenteral nutritional support. We report improved outcome in this case using the technique of enteroclysis feeding of distal loop, making the early closure of stoma possible.


Keywords


Ileosigmoid knot (ISK), Enteroclysis, Ileosigmoid, Bowel Gangrene, Peritonitis, Gangrene

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References


Alver O, Oren D, Tireli M, Kayabasi B, and Akdemis D. (1993). “Ileosigmoid knotting in Turkey: review of 68 cases”, Dis Colon Rectum, Vol.36, pp.1139–1147.

Pendse AK, Khamesra HL, and Babel AL. (1981). “Ileosigmoid knotting”, J Indian Med Assoc, Nov; Vol.77(9-10), pp.161-162.

Saha I, Chatterjee RB, and Saha S. (1978). “Ileosigmoid knotting”, J Indian Med Assoc, Jul 16; Vol.71(2), pp.38-40.

Raveenthiran V. (2001). “The ileosigmoid knot: new observations and changing trends”, Dis Colon Rectum, Aug; Vol.44(8), pp.1196-1200.

Baheti AD, Patel D, Hira P, and Babu D. (2011). “Ileosigmoid knot: A case report”, Indian J Radiol Imaging, Apr; Vol.21(2), pp.147-149.

Mallick IH, and Winslet MC. (2004). “Ileosigmoid knotting”, Colorectal Dis, Vol.6, pp.220–225.

Shepherd JJ. (1968). “Treatment of volvulus of sigmoid colon: a review of 425 cases”, Br Med J, Vol.1, pp.280–283.

Shepherd JJ. (1967). “Ninety two cases of Ileosigmoid knotting in Uganda”, Br J Surg, Vol.54, pp.561–566.

Kakar A, and Bhatnagar BN. (1981). “Ileosigmoid knotting: a clinical study of 11 cases”, Aust NZJ Surg, Vol.51, pp.456–458.

Scott OJ. (1973). “Ileosigmoid knot and sigmoid volvulus”, South Afr J Surg, Vol.11, pp.29-32.

Vaez-Zadeh K, and Dutz W. (1970). “Ileosigmoid knotting”, Ann Surg, Vol.172, pp.1027-1033.

North LB, and Weens HS. (1964). “The intestinal knot syndrome”, AJR, Vol.92, pp.1042-1047.

Young WS, White A, and Grave GF. (1978). “The radiology of ileosigmoid knot”, Clin radiol, Vol.29, pp.211-216.

Watso RG. (1984). “Ileosigmoid knot”, J R Coll Surg Edinb, Vol.29, pp.100-102.

Hsu ML. (1979). “Ileosigmoid knot”, J R Coll Edinb, Vol.24, pp.28-29.

Welch JP. (1990). “Bowel obstruction, differential diagnosis and clinical management”,WB Saunders, Philadelphia, pp.575-88.

Puthu D, Rajan N, Shenoy GM, and Pai US. (1991). “The ileosigmoid knot”, Dis Colon Rectum, Vol.34, pp.161–166.

Versteeg KR, and Whitehead WA. (1980). “Ileosigmoid knot”, Arch Surg, Vol.115, pp.761-763.

Freeman Dahl S. (1942). “Roentgen findings in intestinal knots”, Acta Radiol, Vol.23, pp.22-33.

Roy M, and Roy S. (1973). “Ileosigmoid knot”, J Indian Med Assoc, Jan 16, Vol.60(2), pp.50-53.

White JAM. (1962). “Mesenteric hernia and double volvulus in the African in Rhodesia”, J R Coll Surg Edinb, Vol.7, pp.138-146.

Harbrecht PJ, and Donald EF. (1970). “Recurrence of volvulus after sigmoidectomy”, Dis Colon Rectum, Vol.22, pp.420-424.

Hall-Craggs EC. (1960). “Sigmoid volvulus in an African population”, BMJ, Vol.1, pp.1015-1017.

Ellis H. (1982). “Intestinal obstruction”,Appleton-Century-Crofts, New York, pp.297-299.

Wapnick S. (1973). “Treatment of intestinal volvulus”,. Ann R Coll Surg Engl, Vol.53, pp.57-60.

Boulvin R, Esphahant A, and Tavakoli A. (1969). “494 cas du volvulus aigu du colon”, Chirurgie, Vol.95, pp.467-470.

Inberg MV. (1972). “Acute intestinal volvulus. A report of 238 cases”, Scand J Gastroenterol, Vol.7, pp.209-213.

Buchman AL. (2006). “Etiology and initial management of short bowel syndrome”, Gastroenterology, Vol.130, pp.S5-S15.

Matarese LE, and Steiger E. (2006). “Dietary and medical management of short bowel syndrome in adult patients”, J Clin Gastroenterol, Vol.40, pp.S85-S93.

Tappenden KA. (2006). “Mechanisms of enteral nutrient-enhanced intestinal adaptation”, Gastroenterology; Vol.130, pp.S93-S99.

Soeters PB, Reijven PL, van Bokhorst-de van der Schueren MA, Schols JM, Halfens RJ, Meijers JM, and van Gemert WG. (2008). “A rational approach to nutritional assessment”, Clin Nutr, Oct;27, Vol.5, pp.706-716.

Mohil RS, Narayan N, Singh N, Lal AP, Sreenivas V, and Bhatnagar D. (2010). “Impact of nutritional support on nutritional status and nitrogen balance in surgical patients of a developing country”, Health, Vol.2(12).

Mohil RS, Agarwal A, Singh N, Arora J, and Bhatnagar D. (2008). “Does nutritional status play a role in patients undergoing emergency laparotomy?” e-SPEN, The European e-Journal of Clinical Nutrition and Metabolism, Vol.3, pp.e226-e231.


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