 |
Case Report
Ileo-ileal knotting: An unusual cause of acute strangulated intestinal obstruction
1 Fellow West African College of Surgeons, FWACS (Consultant Surgeon), Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
2 Fellow West African College of Surgeons, FWACS, FCIS, MPH, Consultant General Surgeon, Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
3 Member West African College of Surgeons, MWACS, Senior Registrar, Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
Address correspondence to:
Onyeyirichi Otuu
General Surgery Unit, Department of Surgery, Alex-Ekwueme Federal Teaching Hospital, Abakaliki, Ebonyi State,
Nigeria
Message to Corresponding Author
Article ID: 100088Z12OO2021
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Otuu O, Eni EU, Oguonu AC. Ileo-ileal knotting: An unusual cause of acute strangulated intestinal obstruction. J Case Rep Images Surg 2021;7:100088Z12OO2021.ABSTRACT
Introduction: Intestinal knotting is the obstruction of an intestinal segment with closed loop phenomenon secondary to knotting of the mesentery. Ileo-ileal knotting remains the rarest of all intestinal knotting.
Case Report: A 35-year-old female patient presented to the emergency department with colicky abdominal pain of 5 days duration with associated bilious vomiting, progressive abdominal distention, and constipation. She had four previous caesarean sections. The abdomen was grossly distended with generalized tenderness, guarding, and absent bowel sounds. Plain abdominal roentgenogram showed dilated loops of small bowel with multiple air-fluid levels and absent rectal gas shadow. A diagnosis of complicated adhesive intestinal obstruction was made and patient underwent emergency exploratory laparotomy. The proximal loop of ileum was found to be knotted on the distal ileum with the entrapped loop being gangrenous. She had resection of the gangrenous gut with end-to-end ileal anastomosis and made an uneventful recovery.
Conclusion: A high index of suspicion and immediate surgical intervention is needed in the management of this entity because it can progress rapidly to strangulation.
Keywords: Ileo-ileal knotting, Intestinal knotting, Intestinal obstruction
SUPPORTING INFORMATION
Author Contributions
Onyeyirichi Otuu - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Uche Emmanuel Eni - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Amobi Chiedozie Oguonu - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Onyeyirichi Otuu et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
