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The article evaluates the clinical profiles, surgical experience, and outcomes of 40 patients with ileosigmoid knotting (ISK) at Jimma University Medical Center. ISK is a rare condition with a complex clinical presentation, leading to a relatively long symptom period and high shock rate. Diagnosis is challenging, with CT and MRI being highly diagnostic. Emergency surgical treatment is necessary due to the high bowel gangrene rate and poor prognosis associated with ISK, particularly in certain populations. The authors provide valuable insights based on their extensive experience with ISK cases. [Extracted from the article]

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. [ABSTRACT FROM AUTHOR]

This article discusses a rare case of sigmoid volvulus (SV) complicating pregnancy. SV is a relatively uncommon condition, with less than 120 cases reported to date. The authors provide insights based on their experience with 11 pregnant patients out of a total of 1076 SV cases treated over a 57.5-year period. They highlight that pregnancy can increase the incidence of SV due to the physiological movement of the sigmoid colon being hindered by the enlarged uterus. The diagnosis of SV in pregnant women can be challenging due to overlapping symptoms with pregnancy-related discomforts, and diagnostic tools such as flexible endoscopy or MRI are preferred over X-ray or CT scans to avoid potential fetal radiation risk. Treatment of SV in pregnancy requires collaboration between general surgeons, obstetricians, and pediatricians, with flexible endoscopy being the primary option in uncomplicated cases. Elective surgery is generally delayed to the second trimester, while emergency surgery is required for gangrenous bowel or unsuccessful endoscopic decompression. The prognosis of SV in pregnancy is important, as maternal and fetal mortality rates can range from 6% to 26%. [Extracted from the article]