Ileosigmoid knot: A case report of the lethal twist

Q4 Medicine

Radiology Case Reports Pub Date : 2025-05-13 DOI:10.1016/j.radcr.2025.04.069

Basma Dghoughi MD , Basma Beqqali MD , Kaoutar Maslouhi MD , Hamza Hamdani MD , Omar Sbiyaa MD , Sara Benammi MD , Hamid Mohammadine PhD , Abdellatif Settaf PhD , Zaynab Iraqi Houssaini PhD , Ola Messaoud PhD , Laila Jroundi PhD , Omar El Aoufir PhD

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引用次数: 0

Abstract

Ileosigmoid knot (ISK) is a rare and rapidly fatal surgical emergency characterized by the twisting of the ileum around the sigmoid colon, leading to acute bowel obstruction, ischemia, and gangrene. Due to its nonspecific clinical presentation, ISK is often misdiagnosed causing a delay of definitive treatment. The condition is most frequently reported in regions with high-fiber diets and anatomical predispositions, but remains a globally uncommon entity. Radiological imaging, particularly CT scans, plays a crucial role in preoperative diagnosis, with the whirl sign including sigmoid and ileum being a key diagnostic clue. However, most cases are only confirmed intraoperatively, and outcomes depend on the extent of bowel necrosis and the timeliness of surgical intervention. Mortality rates remain high, particularly in cases complicated by sepsis and multiorgan failure. We present the case of a 49-year-old male who developed acute abdominal pain, with CT imaging and laparotomy confirming an ileosigmoid knot, ultimately resulting in a fatal outcome.

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回肠乙状结肠结：致死性扭转1例

回肠乙状结肠结（ISK）是一种罕见且迅速致命的外科急症，其特征是回肠在乙状结肠周围扭曲，导致急性肠梗阻、缺血和坏疽。由于其非特异性临床表现，ISK经常被误诊，导致最终治疗的延误。这种情况最常见于高纤维饮食和解剖学倾向的地区，但仍然是全球罕见的实体。影像学尤其是CT扫描在术前诊断中起着至关重要的作用，螺旋征包括乙状结肠和回肠是诊断的关键线索。然而，大多数病例仅在术中确诊，其结果取决于肠坏死的程度和手术干预的及时性。死亡率仍然很高，特别是合并败血症和多器官衰竭的病例。我们报告了一个49岁男性急性腹痛的病例，CT成像和剖腹手术证实了回肠乙状结肠结，最终导致了致命的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiology Case Reports Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

1.10

自引率

0.00%

发文量

1074

审稿时长

30 days

期刊介绍： The content of this journal is exclusively case reports that feature diagnostic imaging. Categories in which case reports can be placed include the musculoskeletal system, spine, central nervous system, head and neck, cardiovascular, chest, gastrointestinal, genitourinary, multisystem, pediatric, emergency, women''s imaging, oncologic, normal variants, medical devices, foreign bodies, interventional radiology, nuclear medicine, molecular imaging, ultrasonography, imaging artifacts, forensic, anthropological, and medical-legal. Articles must be well-documented and include a review of the appropriate literature.