Puthu D, Rajan N, Shenoy G M, Pai S U
Department of Surgery, Kasturba Hospital, Manipal, India.
Dis Colon Rectum. 1991 Feb;34(2):161-6. doi: 10.1007/BF02049992.
The ileosigmoid knot (ISK) is a rare cause of intestinal obstruction. Unfamiliarity with the condition could have disastrous consequence at surgery. Over the past 20 years, we have encountered seven cases. Analyzing the data gathered from these, and on reviewing the literature, we found it possible to arrive at a preoperative diagnosis in two patients. Four patients were women, two of whom developed the obstruction in the postpartum period. One of the males was found to have an inflamed Meckel's diverticulum included in the knotting. The symptoms and the clinical findings were nonspecific. The characteristic x-ray findings of a double closed loop obstruction, was seen in only three patients. Resection of gangrenous bowel with anastomoses was feasible in four. Unlike in other series, primary anastomosis of the large gut was undertaken. There were two deaths early in the series. Guidelines to the management have been suggested.
回肠乙状结肠纽结（ISK）是肠梗阻的一种罕见病因。对该病症不熟悉可能在手术时导致灾难性后果。在过去20年里，我们遇到了7例。分析从这些病例收集的数据并查阅文献后，我们发现有两名患者有可能在术前做出诊断。4例为女性，其中2例在产后发生梗阻。1例男性患者的纽结中发现有发炎的梅克尔憩室。症状和临床发现无特异性。仅3例患者出现了双闭环梗阻的典型X线表现。4例可行切除坏疽肠段并进行吻合术。与其他系列不同的是，我们进行了大肠的一期吻合术。该系列早期有2例死亡。已提出了管理指南。
