Intestinal Obstruction by Ileosigmoid Knot: Report of Two Cases at Kara Teaching Hospital (Togo)

The authors report two cases of acute intestinal obstruction by an ileosigmoid node. Both patients were young, male, one 24 years old and the other 31 years old. They were admitted in emergency for an acute intestinal obstruction. Abdominal x-ray showed hydroaeric levels in favor of hail and colonic occlusion in the 24-year-old patient while it showed right colonic distension associated with central hailic hydroaeric levels in the denier. A biological examen noted hyperleukocytosis in both cases. Because of the intensity of the pain and the hyperleukocytosis, a laparotomy was performed urgently, allowing an ileosigmoid knot to be found in both cases. In the first case, the imprisoned ileum was necrotic. As defection of the knot was impossible, resection of the ileum and sigmoid was performed followed by an ileo-ileal and colorectal anastomosis. In the second case, a defection of the knot had been performed allowing re-coloring of the ischemic ileum. A dolichomegasigmoid was also noted. Consequently colectomy had been performed. The postoperative period was marked by death in the first patient due to ionic disorders likely due to delayed treatment.