Index Copernicus IC Value: 85.42
International Journal of Case Reports and Images - IJCRI - Case Reports, Case Series, Case in Images, Clinical Images

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Case Report
 
Ileo-ileal knot causing small bowel gangrene: An unusual presentation
SK Uday1, Pavan Kumar Ch Venkata2, PRK Bhargav3
1Associate Professor, Dept of General Surgery, MMC/MGH, Khammam, Andhra Pradesh, India.
2Assistant Professor, Dept of General Surgery, MMC/MGH, Khammam, Andhra Pradesh, India
3Assistant Professor, Dept of Endocrine Surgery, MMC/MGH; 4Post-Graduate student, MMC/MGH, Khammam, Andhra Pradesh, India.

doi:10.5348/ijcri-2012-05-121-CR-6

Address correspondence to:
Dr. Uday Shamrao Kumbhar, MS, FMAS
Mamata General Hospital, Thungabhadra Quarter No. 5
Giriprasad Nagar, Khammam
Andhra Pradesh
India - 507002
Phone: +91 9676961106
Email: k26uday74@yahoo.co.in

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How to cite this article:
Uday SK, Venkata PKCH, Bhargav PRK, Kumar S. Ileo-ileal knot causing small bowel gangrene: An unusual presentation. International Journal of Case Reports and Images 2012;3(5):28–30.


Abstract
Introduction: Mechanical intestinal obstruction with closed loop phenomenon secondary to knotting of the mesentery is an uncommon entity that can rapidly evolve into ischemia of the intestinal segment that forms the knot. It originates with the wrapping of the mobile ileal loop compromising the mesentery in the center of the knot and is an unusual cause of intestinal strangulation.
Case Report: We report a case of small bowel gangrene caused by ileo-ileal knotting. Patient underwent emergency exploratory laparotomy and resection of gangrenous small bowel segment with end to end anastomosis.
Conclusion: Ileo-ileal knotting should be considered in the differential diagnosis of acute intestinal obstruction associated with abdominal tenderness and absence of peritonitis. Emergent exploratory laparotomy with high index of suspicion yields optimal results.

Key Words: Ileo-ileal knot, Small bowel gangrene, Intestinal obstruction, Laparotomy

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Author Contributions:
SK Uday - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Pavan Kumar Ch Venkata - Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published PRK Bhargav – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Subith Kumar -Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission:
The corresponding author is the guarantor of submission.
Source of support:
None
Conflict of interest:
Authors declare no conflict of interest.
Copyright:
© SK Uday et al. 2012; This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)



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