Case Reports

Ileosigmoid knotting in a child: Index case in Botswana and review of the literature

A G Bedada, M I Sreekumaran, G Azzie

Abstract


Ileosigmoid knotting (ISK) is a rare form of complex intestinal obstruction where a loop of ileum wraps around the base of the sigmoid colon, or vice versa. We report the case of an ill-looking 8-year-old boy who presented with abdominal pain and vomiting. Abdominal examination revealed distension and features of diffuse peritonitis. Complicated appendicitis was at the top of the list of differential diagnoses. The patient was resuscitated and prepared for surgery. At laparotomy, haemorrhagic fluid with gangrenous ileum wrapping around gangrenous sigmoid colon was found. En bloc resection of the gangrenous ileum and sigmoid colon with primary ileo-ileal and descending colorectal anastomoses were done. The patient was discharged on the 10th postoperative day. Although extremely rare in this patient population, surgeons must be able to recognise and manage ISK in children.


Authors' affiliations

A G Bedada, Department of Surgery, Faculty of Medicine, University of Botswana, Princess Marina Hospital, Gaborone, Botswana

M I Sreekumaran, Department of Surgery, Bokamoso Private Hospital, Gaborone, Botswana

G Azzie, Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Canada

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Cite this article

South African Journal of Child Health 2018;12(3):88-89. DOI:10.7196/SAJCH.2018.v12i3.1493

Article History

Date submitted: 2018-09-28
Date published: 2018-09-28

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