Ileo‐ileal knot: a rare cause of acute intestinal obstruction

Rajesh, Aashish; Rengan, Vinayak; Anandaraja, S; Pandyaraj, Angusamy

doi:10.1111/ans.14793

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Clinical treatment for advanced gastric cancer patients to take surgical treatment, the treatment effect is remarkable. However, the distant metastasis of cancer cells and gastrointestinal injury are prone to causing acute intestinal obstruction, which affects treatment and prognosis [ 4 ]. Acute ileus is a mechanical blockage of intestinal contents, resulting in abdominal distention, acid-base electrolyte balance, and vomiting.…”

Section: Introductionmentioning

confidence: 99%

Application Effect of Somatostatin Combined with Transnasal Ileus Catheterization in Patients with Acute Intestinal Obstruction and Advanced Gastric Cancer

Liu

2022

Computational Intelligence and Neuroscience

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Objective: To explore the application of somatostatin combined with nasal plug catheterization in patients with advanced gastric cancer and acute intestinal obstruction. Methods. This study included 94 cases of patients with acute intestinal obstruction and advanced gastric cancer, and according to the length of hospital stay, the patients were randomly divided into two groups: the control group and the study group, with 47 cases in each group. Based on the observations made by the team in the control group given somatostatin combined treatment, we observed two groups of patients with gastrointestinal function, serum index, quality of life, therapeutic effect, and adverse reactions. Results. Abdominal distention, abdominal pain duration, and normal exhaust time were significantly shorter in the study group than in the control group. The study group was higher than the control group in terms of gastrointestinal decompression volume, drainage volume, and abdominal circumference reduction within 24 hours ( P < 0.05 ). After treatment, the levels of CRP, IgA, LPS, and FABP were lower than before, and the levels of CRP, IgA, LPS, and FABP in the former group were much lower than those in the latter group ( P < 0.05 ). Compared with before treatment, the former GIQLI scale score was significantly higher than the latter ( P < 0.05 ). After treatment, the efficiency is much higher than the latter ( P < 0.05 ). After treatment, the former significantly lowers the incidence of postoperative complications of the latter ( P < 0.05 ). Conclusion. For patients with advanced gastric cancer and acute intestinal obstruction, it is safe and feasible to use somatostatin combined with transnasal intestinal obstruction catheterization to restore gastrointestinal function, improve inflammatory response, and promote the improvement of quality of life with high safety and feasibility.

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Section: Introductionmentioning

confidence: 99%

Application Effect of Somatostatin Combined with Transnasal Ileus Catheterization in Patients with Acute Intestinal Obstruction and Advanced Gastric Cancer

Liu

2022

Computational Intelligence and Neuroscience

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“…A search of PubMed and Google Scholar databases revealed 13 cases of IIKs with true knot formation that have been reported from 2010 to 2022 [ 4 , 6 – 16 ], including this case (Table 1 ). Most reported cases were from India (six cases) [ 8 , 9 , 11 – 14 ], followed by Japan (three cases, including this case) [ 4 , 7 ]. The remaining four were from Greece [ 6 ], Ethiopia [ 10 , 16 ], and Malaysia [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Of the 13 previously reported cases, 3 were described as having adhesions related to intestinal knots [ 7 , 11 , 15 ]. Others stated that increased mobility of the intestinal tract promoted knot formation [ 4 , 8 , 14 ]. Since the majority of cases of knot formation occurred within 30 cm proximal of the ileocecal area, it was hypothesized that "moderate adhesions and exaggerated intestinal peristalsis" promote knot formation [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The need for intestinal resection in IIK does not seem to correlate with the onset time. As noted in two cases [ 12 , 14 ], only obstruction release was required even though two days had passed since the onset of symptoms. Therefore, it is speculated that the need for intestinal resection depends not on the time of symptom onset but on the degree of strangulation associated with knot formation.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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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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“…Intestinal obstruction caused by ileo-ileal knot formation is rare, and only 12 cases have been reported since 1990, including in the Japanese literature [1,[3][4][5][6][7][8][9][10] (Table 1). Considering the pathogenesis, the disease might be expected to be more common in older women with less visceral fat, but in the reported cases, it was also found to be quite common in younger people and in men.…”

Section: Discussionmentioning

confidence: 99%

Small bowel obstruction caused by a true ileo-ileal knot: a rare case successfully treated by prior ligation of mesenteric vessels

et al. 2021

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Background Intestinal knot formation, in which two segments of the intestine become knotted together, can result in intestinal obstruction. An ileo-ileal knot refers to knot formation between two ileal segments and is a very rare benign disease. We report a case of strangulated bowel obstruction caused by true ileo-ileal knot formation. Case presentation An 89-year-old woman was referred to our hospital with the diagnosis of intestinal obstruction. Contrast-enhanced computed tomography revealed the small bowel forming a closed loop, with poor contrast effect. Based on the findings, the patient was diagnosed as having strangulated bowel obstruction, and emergency surgery was performed. At laparotomy, two segments of the ileum were found to be tied together forming a knot, and both segments were necrotic. Although it was necessary to release the strangulated small bowel, we did not immediately release the knot, but first proceeded with ligation of the mesenteric vessels to the strangulated small bowel to prevent dissemination of toxic substances from the necrotic bowel into the systemic circulation. The surgery was completed with resection of the necrotic ileum and anastomosis of the small intestine. The postoperative course was uneventful, and the patient was discharged home. Conclusion We encountered a case of strangulated bowel obstruction caused by true ileo-ileal knot formation. Resection of the necrotic small intestine without releasing the knot could be performed safely, and might be considered as an option of surgical procedure.

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Ileo‐ileal knot: a rare cause of acute intestinal obstruction

Cited by 5 publications

References 7 publications

Application Effect of Somatostatin Combined with Transnasal Ileus Catheterization in Patients with Acute Intestinal Obstruction and Advanced Gastric Cancer

Application Effect of Somatostatin Combined with Transnasal Ileus Catheterization in Patients with Acute Intestinal Obstruction and Advanced Gastric Cancer

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

Small bowel obstruction caused by a true ileo-ileal knot: a rare case successfully treated by prior ligation of mesenteric vessels

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