2016 Volume 36 Issue 6 Pages 1069-1072
A 90-year-old male with the chief compliant of abdominal pain was referred to our hospital. Abdominal contrast-enhanced CT revealed extensive dilatation of the small intestine with poor enhancement, a positive whirl sign, and massive ascites. Under the presumed diagnosis of strangulated ileus, we performed emergency laparotomy. Strangulation due to knotting between two loops of the small intestine was confirmed intraoperatively. We performed resection of the involved small intestinal segments after first unknotting the knotted intestines. The residual length of the small intestine was approximately 300 cm. The postoperative course of the patient was uneventful and he was transferred to receive rehabilitation on the 19th postoperative day. In the majority of cases of the intestinal knot syndrome, the knotting occurs between the ileum and the sigmoid colon. Herein, we report a very rare case of an ileoileal-type intestinal knot syndrome (true knot).
