ZenToks Publication

Chapter 5

The Diagnosis and Management of Ileo-Sigmoid Knotting

Abstract/Preface

Ileo-sigmoid knotting represents a rare form of colonic volvulus, characterized by acute intestinal obstruction and a significant risk of gangrene and perforation. Clinically, it manifests as acute intestinal obstruction, and diagnostic imaging techniques such as abdominal radiographs and computed tomography can facilitate its identification. However, diagnosis is frequently confirmed intra-operatively. The management of ileo-sigmoid knotting necessitates surgical intervention, involving the release of the volvulus segment and resection of the non-viable ileal segment, followed by anastomosis. Additionally, a sigmoid colectomy is performed, and depending on the colon’s viability, either an anastomosis or stoma formation is executed. This chapter will explore the diagnosis, classification, and management of ileo-sigmoid knotting.