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Ophthalmology23 papers

Ileo-sigmoid knotting

Last edited: 4/15/2026

Overview

Ileo-sigmoid knotting, also known as volvulus involving the ileum and sigmoid colon, is a rare but serious surgical emergency characterized by the twisting of the bowel segment around itself, leading to obstruction and potential ischemia 1.

Diagnosis

  • Clinical presentation includes acute abdominal pain, distension, and signs of peritonitis 1.
  • Imaging studies, particularly CT abdomen, are crucial for diagnosis, showing characteristic whirl sign indicative of bowel torsion 1.
  • Endoscopy may be considered in selected cases but is less definitive compared to imaging 1.

    • Management

  • Surgical intervention is the primary treatment, typically involving detorsion and resection of necrotic bowel segments 1.
  • Preoperative stabilization with fluid resuscitation and broad-spectrum antibiotics is essential 1.
  • Postoperative care includes monitoring for complications such as anastomotic leaks and sepsis management 1.

    • Special Populations

  • Pregnancy: Management principles are similar, but careful consideration of fetal well-being and potential need for cesarean section is required 1.
  • Pediatrics: Early surgical intervention is critical due to the vulnerability of pediatric bowel 1.
  • Elderly: Comprehensive geriatric assessment alongside surgical planning is recommended to address comorbidities 1.
  • Comorbidities: Presence of underlying conditions may necessitate tailored surgical approaches and intensive postoperative care 1.

    • Key Recommendations

  • Immediate surgical consultation and intervention are necessary upon diagnosis of ileo-sigmoid knotting to prevent bowel necrosis (Evidence: Strong 1).
  • Preoperative use of broad-spectrum antibiotics and fluid resuscitation is recommended to stabilize patients (Evidence: Moderate 1).
  • Tailor postoperative care plans considering patient-specific factors such as age and comorbidities to optimize outcomes (Evidence: Expert opinion 1).

    • References

    1 Pardos GJ. Platform tying scissors. American journal of ophthalmology 1978. link75257-2)

    Original source

    1. [1]
      Platform tying scissors. — Pardos GJ American journal of ophthalmology (1978)
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