Ileosigmoid Knotting: A Rare But Lethal Cause of Acute Intestinal Obstruction - A Narrative Review

Dr. Pawan Tiwari, Dr. Ajay Kumar, Dr. Madhu Tiwari, Dr. Palak Sheoran, Vikramaditya Bhati, Shefali Kaushik, Deepankur Bansal, Rohit Kumar Repaswal

Abstract: Ileosigmoid knotting (ISK) is a rare and potentially fatal surgical emergency characterized by wrapping of the ileum around the sigmoid colon or vice versa, resulting in a closed-loop obstruction with rapid progression to strangulation and gangrene [1,2]. The condition is predominantly reported from regions with a high incidence of sigmoid volvulus and commonly affects adult males [3,4]. Preoperative diagnosis is challenging due to nonspecific clinical features and overlapping radiological findings with other causes of bowel obstruction [5,6]. Delayed presentation and limited access to advanced imaging further worsen outcomes, particularly in resource-limited settings [7]. Early recognition, aggressive resuscitation, and emergency surgical intervention are critical to reducing morbidity and mortality [2,8]. This review summarizes the epidemiology, etiopathogenesis, clinical presentation, diagnostic challenges, operative management, and outcomes of ileosigmoid knotting, with emphasis on evidence from published case series and reviews.

Keywords: Acute abdomen, Gangrene, Ileosigmoid knotting, Intestinal obstruction, Volvulus

How to Cite?: Dr. Pawan Tiwari, Dr. Ajay Kumar, Dr. Madhu Tiwari, Dr. Palak Sheoran, Vikramaditya Bhati, Shefali Kaushik, Deepankur Bansal, Rohit Kumar Repaswal, "Ileosigmoid Knotting: A Rare But Lethal Cause of Acute Intestinal Obstruction - A Narrative Review", Volume 15 Issue 1, January 2026, International Journal of Science and Research (IJSR), Pages: 1626-1630, https://www.ijsr.net/getabstract.php?paperid=MR26116133920, DOI: https://dx.doi.org/10.21275/MR26116133920