Ileosigmoid knot at week 13 of pregnancy: report of a case.
The ileosigmoid knot (ISK) is a rare cause of intestinal obstruction. ISK is a condition in which the ileum wraps around the base of the sigmoid colon and forms a knot, leading to high mortality with rapid progression to bowel gangrene. We herein report a rare case of ISK at week 13 of pregnancy. The ISK was diagnosed by computed tomography, and the patient underwent emergency surgery for acute abdomen. Laparotomy showed segmental gangrenous change in the sigmoid colon, which was twisted around the distal ileal loop. The gangrenous bowel was resected, and primary anastomosis was performed. To our knowledge, the present case involves the first and earliest pregnancy in which a preoperative diagnosis of ISK was made and successful treatment was performed with surgery. A radiologic approach should be undertaken for prompt diagnosis and optimal management, even in early pregnancy.
1 Department of Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
Riha
R
Shimizu
Yoshinori
Y
Hoshino
Haruko
H
Irie
Homare
H
Ito
Toshiaki
T
Terauchi
Masaru
M
Kimata
Junji
J
Furukawa
Hiroharu
H
Shinozaki
Kenji
K
Kobayashi
Yoshiro
Y
Ogata
D000006:Abdomen, Acute / Q000209:etiology / Q000601:surgery; D000328:Adult; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012810:Sigmoid Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
Emergency surgery; Ileosigmoid knot; Pregnancy; Small bowel obstruction; Strangulation