Two Cases of Preoperatively Diagnosed Ileosigmoid Knot
Intestinal knots can rarely cause acute abdomen. Knots in the ileum and sigmoid colon are called ileosigmoid knots (ISK). We encountered 2 cases of ISK, which we were able to diagnose preoperatively. In case 1, a loop of ileum was wrapped around the base of the sigmoid colon in a clockwise direction...
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| Published in | Nippon Shokaki Geka Gakkai zasshi Vol. 45; no. 1; pp. 93 - 100 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society of Gastroenterological Surgery
01.01.2012
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9768 1348-9372 |
| DOI | 10.5833/jjgs.45.93 |
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| Abstract | Intestinal knots can rarely cause acute abdomen. Knots in the ileum and sigmoid colon are called ileosigmoid knots (ISK). We encountered 2 cases of ISK, which we were able to diagnose preoperatively. In case 1, a loop of ileum was wrapped around the base of the sigmoid colon in a clockwise direction, leading to the formation of a knot; we diagnosed this as ISK type IA. Partial resection of the ileum was performed. The clinical course was good without any complications. In case 2, a loop of the sigmoid colon was wrapped around the base of the ileum in a clockwise direction, causing intestinal obstruction; we diagnosed this as ISK type IIA. The sigmoid colon showed necrotic changes requiring resection. The patient died the day after surgery due to septic shock. ISK is a rare cause of ileus (about 1% of intestinal obstruction cases). The preoperative diagnosis of ISK is difficult, however, we were able to diagnose ISK before surgery by identifying important characteristics such as a "whirl sign" and double closed loop. |
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| AbstractList | Intestinal knots can rarely cause acute abdomen. Knots in the ileum and sigmoid colon are called ileosigmoid knots (ISK). We encountered 2 cases of ISK, which we were able to diagnose preoperatively. In case 1, a loop of ileum was wrapped around the base of the sigmoid colon in a clockwise direction, leading to the formation of a knot; we diagnosed this as ISK type IA. Partial resection of the ileum was performed. The clinical course was good without any complications. In case 2, a loop of the sigmoid colon was wrapped around the base of the ileum in a clockwise direction, causing intestinal obstruction; we diagnosed this as ISK type IIA. The sigmoid colon showed necrotic changes requiring resection. The patient died the day after surgery due to septic shock. ISK is a rare cause of ileus (about 1% of intestinal obstruction cases). The preoperative diagnosis of ISK is difficult, however, we were able to diagnose ISK before surgery by identifying important characteristics such as a "whirl sign" and double closed loop. |
| Author | Taga, Satoshi Etoh, Eiichi Kamachi, Kenichi Yano, Koichi Shimauchi, Takahiro Niijima, Natsuko Ishida, Shingo Akimoto, Hisafumi Ueno, Yosuke |
| Author_xml | – sequence: 1 fullname: Taga, Satoshi organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Etoh, Eiichi organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Yano, Koichi organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Shimauchi, Takahiro organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Akimoto, Hisafumi organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Ueno, Yosuke organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Ishida, Shingo organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Kamachi, Kenichi organization: Department of Surgery, Shin-Mizumaki Hospital – sequence: 1 fullname: Niijima, Natsuko organization: Department of Surgery, Shin-Mizumaki Hospital |
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| Cites_doi | 10.1007/BF02052263 10.1001/archsurg.1980.01380060059017 10.1007/BF02049992 10.1046/j.1445-1433.2003.02793.x 10.3919/jjsa.60.2135 10.1097/00000658-197012000-00016 10.3919/jjsa.63.1929 10.1111/j.1463-1318.2004.00361.x 10.3919/jjsa.69.863 10.1007/s00261-005-0315-7 |
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| References | 2) 古川大輔，堂脇昌一，岡本祐一，今泉俊秀，幕内博康．術前診断したileosigmoid knotの1例．日本臨床外科学会雑誌．2008;69(4):863-6. 11) Alver O, Oren D, Tireli M, Kayabasi B, Akdemir D. Ileosigmoid knotting in Turkey. Review of 68 cases. Dis Colon Rectum. 1993 Dec;36(12):1139-47. 14) Hirano Y, Hara T, Horichi Y, Nozawa H, Nakada K, Oyama K, et al. Ileosigmoid knot: case report and CT findings. Abdom Imaging. 2005 Nov-Dec;30(6):674-6. 5) Hashimoto T, Yamaguchi J, Fujioka H, Okada H, Izawa K, Kanematsu T. Two cases of ileosigmoid knot: the youngest reported patient and CT findings. Hepatogastroenterology. 2004 May-Jun;51(57):771-3. 12) Tamura M, Shinagawa M, Funaki Y. Ileosigmoid knot: computed tomography findings and the mechanism of its formation. ANZ J Surg. 2004 Mar;74(3):184-6. 4) 森山初男，菊池暢之，春木哲哉，野口 剛，菊池隆一，内田雄三．胃切除後に発症したileosigmoid knotの1例．日本臨床外科学会雑誌．1999;60(8):2135-8. 7) 中津基貴，渡辺 脩，坂本一博，倉沢恒雄，前川 博，村松正久．回腸末端を巻き込んだS状結腸軸捻転症（腸管結節形成症）．日本救急医学会関東地方会雑誌．1993;14(1):64-5. 10) 井上匡美，竹中博昭，角村純一，岩瀬和裕，三木康影，別所俊哉，ほか．Ileosigmoid Knotの1例．腹部救急診療の進歩．1993;13(2):243-5. 8) Puthu D, Rajan N, Shenoy GM, Pai SU. The ileosigmoid knot. Dis Colon Rectum. 1991 Feb;34(2):161-6. 15) Vaez-Zadeh K, Dutz W. Ileosigmoid knotting. Ann Surg. 1970 Dec;172(6):1027-33. 1) 日高 渉，長谷川洋，坂本英至，小松俊一郎，久留宮康浩，法水信治，ほか．MDCTで特徴的な画像が得られたileosigmoid knotの1例．日本腹部救急医学会雑誌．2010;30(4):557-61. 3) 伊神 剛，長谷川洋，小木曽清二，坂本英至，太平周作，森 俊治．興味あるCT像を呈したileosigmoid knotの1例．日本臨床外科学会雑誌．2002;63(8):1929-33. 9) VerSteeg KR, Whitehead WA. Ileosigmoid knot. Arch Surg. 1980 Jun;115(6):761-3. 6) 山本 透，松尾信昭，和田譲二，上殿泰成，木内俊一郎，田中孝也，ほか．高齢者に発症したIleosigmoid Knotの1例 腸管結節形成症の本邦集計を含めて．日本腹部救急医学会雑誌．1996;16(6):1179-82. 13) Mallick IH, Winslet MC. Ileosigmoid knotting. Colorectal Dis. 2004 Jul;6(4):220-5. 11 12 YAMAMOTO TOORU (6) 1996; 16 13 14 15 2 3 4 5 8 9 INOUE MASAYOSHI (10) 1993; 13 NAKATSU MOTOKI (7) 1993; 14 HIDAKA WATARU (1) 2010; 30 |
| References_xml | – reference: 8) Puthu D, Rajan N, Shenoy GM, Pai SU. The ileosigmoid knot. Dis Colon Rectum. 1991 Feb;34(2):161-6. – reference: 7) 中津基貴，渡辺 脩，坂本一博，倉沢恒雄，前川 博，村松正久．回腸末端を巻き込んだS状結腸軸捻転症（腸管結節形成症）．日本救急医学会関東地方会雑誌．1993;14(1):64-5. – reference: 13) Mallick IH, Winslet MC. Ileosigmoid knotting. Colorectal Dis. 2004 Jul;6(4):220-5. – reference: 12) Tamura M, Shinagawa M, Funaki Y. Ileosigmoid knot: computed tomography findings and the mechanism of its formation. ANZ J Surg. 2004 Mar;74(3):184-6. – reference: 6) 山本 透，松尾信昭，和田譲二，上殿泰成，木内俊一郎，田中孝也，ほか．高齢者に発症したIleosigmoid Knotの1例 腸管結節形成症の本邦集計を含めて．日本腹部救急医学会雑誌．1996;16(6):1179-82. – reference: 1) 日高 渉，長谷川洋，坂本英至，小松俊一郎，久留宮康浩，法水信治，ほか．MDCTで特徴的な画像が得られたileosigmoid knotの1例．日本腹部救急医学会雑誌．2010;30(4):557-61. – reference: 11) Alver O, Oren D, Tireli M, Kayabasi B, Akdemir D. Ileosigmoid knotting in Turkey. Review of 68 cases. Dis Colon Rectum. 1993 Dec;36(12):1139-47. – reference: 4) 森山初男，菊池暢之，春木哲哉，野口 剛，菊池隆一，内田雄三．胃切除後に発症したileosigmoid knotの1例．日本臨床外科学会雑誌．1999;60(8):2135-8. – reference: 10) 井上匡美，竹中博昭，角村純一，岩瀬和裕，三木康影，別所俊哉，ほか．Ileosigmoid Knotの1例．腹部救急診療の進歩．1993;13(2):243-5. – reference: 15) Vaez-Zadeh K, Dutz W. Ileosigmoid knotting. Ann Surg. 1970 Dec;172(6):1027-33. – reference: 9) VerSteeg KR, Whitehead WA. Ileosigmoid knot. Arch Surg. 1980 Jun;115(6):761-3. – reference: 2) 古川大輔，堂脇昌一，岡本祐一，今泉俊秀，幕内博康．術前診断したileosigmoid knotの1例．日本臨床外科学会雑誌．2008;69(4):863-6. – reference: 14) Hirano Y, Hara T, Horichi Y, Nozawa H, Nakada K, Oyama K, et al. Ileosigmoid knot: case report and CT findings. Abdom Imaging. 2005 Nov-Dec;30(6):674-6. – reference: 5) Hashimoto T, Yamaguchi J, Fujioka H, Okada H, Izawa K, Kanematsu T. Two cases of ileosigmoid knot: the youngest reported patient and CT findings. Hepatogastroenterology. 2004 May-Jun;51(57):771-3. – reference: 3) 伊神 剛，長谷川洋，小木曽清二，坂本英至，太平周作，森 俊治．興味あるCT像を呈したileosigmoid knotの1例．日本臨床外科学会雑誌．2002;63(8):1929-33. – ident: 11 doi: 10.1007/BF02052263 – ident: 9 doi: 10.1001/archsurg.1980.01380060059017 – volume: 13 start-page: 243 issn: 0289-5021 issue: 2 year: 1993 ident: 10 – ident: 5 – volume: 14 start-page: 64 issn: 0287-301X issue: 1 year: 1993 ident: 7 – ident: 8 doi: 10.1007/BF02049992 – ident: 12 doi: 10.1046/j.1445-1433.2003.02793.x – ident: 4 doi: 10.3919/jjsa.60.2135 – ident: 15 doi: 10.1097/00000658-197012000-00016 – ident: 3 doi: 10.3919/jjsa.63.1929 – volume: 30 start-page: 557 issn: 1340-2242 issue: 4 year: 2010 ident: 1 – volume: 16 start-page: 1179 issn: 1340-2242 issue: 6 year: 1996 ident: 6 – ident: 13 doi: 10.1111/j.1463-1318.2004.00361.x – ident: 2 doi: 10.3919/jjsa.69.863 – ident: 14 doi: 10.1007/s00261-005-0315-7 |
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| Snippet | Intestinal knots can rarely cause acute abdomen. Knots in the ileum and sigmoid colon are called ileosigmoid knots (ISK). We encountered 2 cases of ISK, which... |
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| SubjectTerms | ileosigmoid knot ileus preoperative diagnosis |
| Title | Two Cases of Preoperatively Diagnosed Ileosigmoid Knot |
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