Abstract
A 20-year-old woman with no previous histories including laparotomy was referred to our hospital complaining of abdominal pain. An abdominal contrast-enhanced CT scan revealed an extensively dilated small intestine with poor imaging effect, wall thickening with hemorrhagic necrosis and massive ascites in the pelvic space. We diagnosed the case as strangulation ileus and performed an emergency laparotomy. In intraoperative findings a loop of the ileum was wrapped by another loop of the ileum. Both loops became necrotic. Strangulation ileus due to knotting two loops of the ileum was diagnosed and we performed an ileocecal resection including a 130-cm long segment of intestine proximal to the necrotized terminal ileum. She resumed to have meal from the 4th post operative day. The clinical course was good and she was discharged on the 11th postoperative day.
Ileo-ileal knot causing strangulation ileus is very rare. The disease can evolve into ischemia and progress rapidly. In treating strangulation ileus, a possibility of this disease should be kept in mind.
