Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report

Abstract Background Intestinal knot formation is a condition wherein two segments of the intestine are knotted together; however, reports of small-intestinal ileo-ileal knot formation are rare. Case presentation The patient was a 62-year-old Asian male with a history of endoscopic colorectal adenoma...

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Main Authors: Satoko Umetsu, Shigeru Shibata, Harue Akasaka, Shinji Tsutsumi, Chiaki Uchida, Hirokazu Ogasawara
Format: Article
Language:English
Published: Japan Surgical Society 2023-08-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-023-01724-6
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author Satoko Umetsu
Shigeru Shibata
Harue Akasaka
Shinji Tsutsumi
Chiaki Uchida
Hirokazu Ogasawara
author_facet Satoko Umetsu
Shigeru Shibata
Harue Akasaka
Shinji Tsutsumi
Chiaki Uchida
Hirokazu Ogasawara
author_sort Satoko Umetsu
collection DOAJ
description Abstract Background Intestinal knot formation is a condition wherein two segments of the intestine are knotted together; however, reports of small-intestinal ileo-ileal knot formation are rare. Case presentation The patient was a 62-year-old Asian male with a history of endoscopic colorectal adenoma resection and a spontaneous pneumothorax. The patient had no history of a laparotomy. He consulted his local doctor with the chief complaint of abdominal pain and was admitted to our hospital with suspicion of an acute abdomen. The abdomen had muscular guarding with tenderness and rebound tenderness. Contrast-enhanced computed tomography (CT) showed torsion of the mesentery of the small intestine with poor contrast filling. The patient was referred to our department with strangulated bowel obstruction and underwent an emergency laparotomy. Intraoperative findings revealed that two segments of the ileum were wrapped around each other to form a knot, and the strangulated small bowel was necrotic. After the release of the knot, partial resection of the small intestine was performed from 220 cm distal to the ligament of Treitz to 80 cm proximal to the cecum. The patient had a good postoperative course and was discharged on the 11th postoperative day. Conclusion Ileo-ileal knots should be considered as part of the differential diagnosis when treating strangulated bowel obstruction.
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issn 2198-7793
language English
publishDate 2023-08-01
publisher Japan Surgical Society
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series Surgical Case Reports
spelling doaj-art-daa0c1d62fe64d74be84f67cbafd64312025-08-20T03:58:50ZengJapan Surgical SocietySurgical Case Reports2198-77932023-08-01911510.1186/s40792-023-01724-6Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case reportSatoko Umetsu0Shigeru Shibata1Harue Akasaka2Shinji Tsutsumi3Chiaki Uchida4Hirokazu Ogasawara5Department of Gastroenterological Surgery, Hirosaki General Medical CenterDepartment of Gastroenterological Surgery, Hirosaki General Medical CenterDepartment of Gastroenterological Surgery, Hirosaki General Medical CenterDepartment of Gastroenterological Surgery, Hirosaki General Medical CenterDepartment of Gastroenterological Surgery, Hirosaki General Medical CenterDepartment of Gastroenterological Surgery, Hirosaki General Medical CenterAbstract Background Intestinal knot formation is a condition wherein two segments of the intestine are knotted together; however, reports of small-intestinal ileo-ileal knot formation are rare. Case presentation The patient was a 62-year-old Asian male with a history of endoscopic colorectal adenoma resection and a spontaneous pneumothorax. The patient had no history of a laparotomy. He consulted his local doctor with the chief complaint of abdominal pain and was admitted to our hospital with suspicion of an acute abdomen. The abdomen had muscular guarding with tenderness and rebound tenderness. Contrast-enhanced computed tomography (CT) showed torsion of the mesentery of the small intestine with poor contrast filling. The patient was referred to our department with strangulated bowel obstruction and underwent an emergency laparotomy. Intraoperative findings revealed that two segments of the ileum were wrapped around each other to form a knot, and the strangulated small bowel was necrotic. After the release of the knot, partial resection of the small intestine was performed from 220 cm distal to the ligament of Treitz to 80 cm proximal to the cecum. The patient had a good postoperative course and was discharged on the 11th postoperative day. Conclusion Ileo-ileal knots should be considered as part of the differential diagnosis when treating strangulated bowel obstruction.https://doi.org/10.1186/s40792-023-01724-6Ileo-ileal knotIntestinal knotStrangulated bowel obstruction
spellingShingle Satoko Umetsu
Shigeru Shibata
Harue Akasaka
Shinji Tsutsumi
Chiaki Uchida
Hirokazu Ogasawara
Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report
Surgical Case Reports
Ileo-ileal knot
Intestinal knot
Strangulated bowel obstruction
title Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report
title_full Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report
title_fullStr Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report
title_full_unstemmed Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report
title_short Strangulated bowel obstruction caused by an ileo-ileal knot: a rare case report
title_sort strangulated bowel obstruction caused by an ileo ileal knot a rare case report
topic Ileo-ileal knot
Intestinal knot
Strangulated bowel obstruction
url https://doi.org/10.1186/s40792-023-01724-6
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AT harueakasaka strangulatedbowelobstructioncausedbyanileoilealknotararecasereport
AT shinjitsutsumi strangulatedbowelobstructioncausedbyanileoilealknotararecasereport
AT chiakiuchida strangulatedbowelobstructioncausedbyanileoilealknotararecasereport
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