Ileosigmoid knotting: A review of 923 cases

  • Sabri Selcuk Atamanalp Ataturk University, Faculty of Medicine, Department of General Surgery, Erzurum
  • Esra Disci, Assist. Prof. MD. Ataturk University Faculty of Medicine Department of General Surgery
  • Rifat Peksoz, Assist. Prof. MD. Ataturk University Faculty of Medicine Department of General Surgery
  • Refik Selim Atamanalp, Assist. MD. Prof. Dr. Cemil Tascioglu City Hospital Department of Pathology İstanbul
  • Cansu Tatar Atamanalp, Assist. MD. Haseki Education and Research Hospital Department of Pediatrics İstanbul
Keywords: Sigmoid colon, Ileum, Ileosigmoid knotting, Intestinal obstruction


Objectives: Ileosigmoid knotting (ISK) is a rare intestinal obstruction form worldwide. The aim of this study was to investigate changing trends in ISK.

Methods: The Web of Science and PubMed databases were electronically searched to find all publications to evaluate all epidemiological, etiological, clinical, laboratory, radiological, therapeutic, and prognostic factors in ISK.

Results: Most of the cases were reported from Asian and African countries. Mean age was 43.9 years with a 79.9%/20.1% of male/female ratio. Main symptom period was 48.1 hours, while the most common clinical features were abdominal pain/tenderness (99.1%), distention (88.3%), and obstipation/constipation (58.8%). Abdominal X-ray radiography, computerized tomography (CT), and magnetic resonance imaging (MRI) were diagnostic in 8.2%, 96.2%, and 100.0%, respectively, while the total diagnostic accuracy rate was 20.8%. Bowels were gangrenous in 85.6% of the patients. Ileum resection was applied in 14.0% of the cases, while sigmoid colon resection in 7.6%, and both segment resection in 67.1%. The mortality rate was 22.7%, while the morbidity rate was also 22.7%.

Conclusion: ISK is a rare disease, but it is still catastrophic despite its two-century recognised past. As an exception, diagnostic convenience arising from CT or MRI looks like the most important change over the last half-century.


How to cite this:
Atamanalp SS, Disci E, Peksoz R, Atamanalp RS, Tatar Atamanalp C. Ileosigmoid knotting: A review of 923 cases. Pak J Med Sci. 2022;38(3):711-715. doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to Cite
Atamanalp, S. S., Disci, E., Peksoz, R., Atamanalp, R. S., & Tatar Atamanalp, C. (2022). Ileosigmoid knotting: A review of 923 cases. Pakistan Journal of Medical Sciences, 38(3).

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