title: Treatment for ileosigmoid knotting: a single-center experience of 74 patients.
abstract: BACKGROUND
  Ileosigmoid knotting (ISK) is the wrapping of the ileum around the base of the sigmoid colon. The purpose of this study was to investigate the outcomes for patients undergoing various treatments for ISK.
  
  
  METHODS
  The clinical records of 74 ISK patients, over 46.5 years, were reviewed retrospectively.
  
  
  RESULTS
  Emergency surgical procedures included resection with primary anastomosis or stoma for patients with gangrenous bowel segments, and detorsion or an additional definitive procedure for patients with viable bowel. Application of these procedures resulted in mortality rates of 0.0% in 14 patients with viable bowel, 12.5% in 8 patients with ileal gangrene, 14.3% in 7 patients with sigmoid colon gangrene, and 28.9% in 45 patients with double-segment gangrene.
  
  
  CONCLUSIONS
  The principal strategy in the treatment for ISK is early and effective resuscitation followed by emergency surgery, including untying the knot, excising the gangrenous bowel segment, restoring intestinal continuity by primary anastomosis if possible, and preventing recurrence in selected patients.
authors.affiliation: Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey, ssa@atauni.edu.tr.
authors.forename: S
authors.initials: S
authors.lastname: Selçuk Atamanalp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002648:Child; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D045822:Intestinal Volvulus / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012810:Sigmoid Diseases / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome