Ileocecal knotting as a rare cause of small bowel obstruction: a case report.

Autor:	Dallakoti N; B.P. Koirala Institute of Health Sciences., Pant VP; B.P. Koirala Institute of Health Sciences., Pokhrel N; B.P. Koirala Institute of Health Sciences., Bhatta P; B.P. Koirala Institute of Health Sciences., Rana VK; Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal., Sah RP; Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Jazyk:	angličtina
Zdroj:	Annals of medicine and surgery (2012) [Ann Med Surg (Lond)] 2024 Feb 28; Vol. 86 (4), pp. 2339-2342. Date of Electronic Publication: 2024 Feb 28 (Print Publication: 2024).
DOI:	10.1097/MS9.0000000000001800
Abstrakt:	Introduction: Ileocecal knot syndrome, a rare cause of small bowel obstruction where the ileum wraps around the cecum, poses a significant challenge for preoperative diagnosis. Prompt intervention is crucial due to the risk of rapid bowel deterioration and increased mortality. Case Presentation: A 45-year-old female presented with central abdominal pain associated with vomiting, abdominal distension, and obstipation. On examination, she was ill-looking with hypotension, tachycardia with a feeble pulse, direct and rebound abdominal tenderness, and absent bowel sounds. Aggressive fluid resuscitation was done. Based on the clinical presentation and abdominal radiograph suggestive of intestinal obstruction, an emergency exploratory laparotomy was done, which showed an ileocecal knot and 130 cm of gangrenous ileum. Peritoneal lavage followed by resection of non-viable ileum with double barrel ileostomy was done. Discussion: Ileosigmoid, appendico-ileal, ileoileal, and ileocecal knotting are the various types of intestinal knotting, with very few cases of ileocecal knotting being reported. Intestinal knotting causes severe bowel obstruction, resulting in reduced mucosal perfusion, progressive ischemia, and peritonitis, leading to high mortality. X-ray findings of multiple air-fluid levels are non-specific, and for definitive diagnosis, laparotomy is required. Assessing bowel viability before definitive surgery is essential. Despite positive outcomes, extensive resection can lead to malabsorption and ileus, with potential risk for developing short bowel syndrome. Conclusion: Despite its rarity, the possibility of ileocecal knotting should be considered in cases of small bowel obstruction due to its potential for rapid deterioration. Prompt resuscitation followed by emergency laparotomy is necessary to prevent mortality. Competing Interests: There are no conflicts to be declared.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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