Twists and turns: unraveling the mystery of ileosigmoidal knotting, a rare and intriguing acute intestinal obstruction (a report of 3 cases).

Abstract

Among the rare and complex causes of acute intestinal occlusion: volvulus due to the ileosigmoid node. The latter is secondary to the terminal ileum which will wrap around the base of the sigmoid colon and its meso, resulting in the formation of a node. Its natural evolution is the ischemia of the ileum and sigmoid, necessitating prompt emergency surgical intervention as the primary treatment approach. In this series, we present three cases from the Department of Digestive Surgery at Arrazi Hospital, Mohammed VI University Hospital in Marrakech, while reviewing the physiopathology, the clinical presentation of this rare entity, as well as the different therapeutic options of the ileosigmoid nodes. We report three cases in the Department of Digestive Surgery at Arrazi Hospital, Mohammed VI University Hospital in Marrakech, in which the diagnosis of ileosigmoid knotting was made by means of computed tomography (CT) scan data and confirmed intraoperatively. Through these 3 reported cases and in the light of data from the literature, we will discuss the different diagnostic, therapeutic, and prognostic aspects of this very rare type of volvulus.