Ileosigmoid Knotting : A Report of Two Cases
port harcourt med. J
; 1(3): 197-200, 2007.
Article
in English
| AIM
| ID: biblio-1274014
Responsible library:
CG1.1
ABSTRACT
Background:
Ileosigmoid knotting (ISK) is a rare cause of acute intestinal obstruction with high morbidity and mortality. The diagnosis is rarely made preoperatively because of its infrequency and the variations in presentation.Aim:
To report two cases managed by the author; which will hopefully increase awareness of this condition.Case Reports The first was a 51-year-old man who presented with a sudden onset of colicky lower abdominal pain; which later became generalized. His pulse rate was 100 beats/minute while his blood pressure was 80/60 mmHg.There was mild abdominal distension with absent bowel sounds. The second was a 50-year-old man with a sudden onset of generalized colicky abdominal pain; abdominal distension and vomiting. His pulse rate was 120 beats/minute and the blood pressure 80/50 mmHg. His bowel sounds were markedly reduced. They were resuscitated accordingly. In both patients; exploratory laparotomy revealed a copious amount of sero-sanguinous fluid in the peritoneal cavity with ileosigmoid knotting; and extensive gangrene involving the distal ileum and the sigmoid colon. In the first patient; the caecum was involved in the knot and therefore also gangrenous. Each of them had a sigmoid colectomy with a right hemicocetomy. The first patient died of adult respiratory distress syndrome while the other had an uneventful recovery. In the patient who died; surgery was done on the third day of onset of symptoms.Conclusion:
A high index of suspicion; aggressive resuscitation; and prompt surgical intervention are indispensable for a successfuloutcome:
Full text:
Available
Index:
AIM (Africa)
Main subject:
Colon, Sigmoid
/
Colectomy
/
Colon
/
Gangrene
/
Intestinal Obstruction
Language:
English
Journal:
Port harcourt med. J
Year:
2007
Type:
Article
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