title: Ileosigmoid knotting: clinical appearance of 73 cases over 45.5 years.
abstract: BACKGROUND
  Ileosigmoid knotting (ISK) is the wrapping of the ileum around the base of the sigmoid colon. The aim of this study was to investigate the clinical outcomes of 73 patients with ISK over 45.5 years.
  
  
  METHODS
  The clinical records were reviewed retrospectively.
  
  
  RESULTS
  The age range was 7-92 years (mean 46.7 years), and 54 patients (74.0%) were male. Forty-two patients (57.5%) experienced shock. The symptom duration range was 12-120 h (mean 46.5 h). The most common clinical features were abdominal pain and tenderness in 73 patients (100.0%), obstipation in 72 patients (98.6%), distention in 70 patients (95.9%) and vomiting in 61 patients (83.6%). The rate of correct diagnosis was 4.1% when based on clinical and X-ray findings (3/73) and 100.0% when based on computed tomography or magnetic resonance imaging findings (4/4 and 2/2, respectively). The diagnosis of ISK was confirmed by surgery in all cases.
  
  
  CONCLUSIONS
  ISK is a rare disease that occurs most commonly in adult men. The disease is generally associated with shock, and the clinical features generally present as a mechanical bowel obstruction. Although X-rays may aid diagnosis, computed tomography and magnetic resonance imaging are more reliable diagnostic tools. However, the diagnosis is made at laparotomy in some cases.
authors.affiliation: Department of General Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey. ssa@atauni.edu.tr
authors.forename: Sabri Selçuk
authors.initials: SS
authors.lastname: Atamanalp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003082:Colectomy; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000601:surgery; D007082:Ileum / Q000601:surgery; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000175:diagnosis* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult