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Ileo-sigmoid knotting: a review of 61 cases in Kenya.
- Source :
-
The Pan African medical journal [Pan Afr Med J] 2016 Apr 15; Vol. 23, pp. 198. Date of Electronic Publication: 2016 Apr 15 (Print Publication: 2016). - Publication Year :
- 2016
-
Abstract
- Introduction: Ileo-sigmoid knotting (ISK) is a rare cause of bowel obstruction in which the ileum twists around the sigmoid colon. It is associated with rapid bowel gangrene and a high mortality rate. Little has been published about this condition in Kenya. The objective was to determine the presentation, management, and outcome of patients with ISK.<br />Methods: A seven year (January 2008-December 2014) retrospective chart review of patients managed for ISK at Tenwek Hospital in Bomet, Kenya.<br />Results: A total of 61 cases were identified, with a mean age of 35.8 years (range 2-68), and mean symptom duration of 1.6 days (range 3 hours-7 days). Gangrene was noted to involve both the ileum and colon in 45 patients, the ileum only in 9 patients, and the sigmoid colon only in one. Resection and primary anastomosis was carried out in most cases of gangrenous ileum (48/54, 89%) and gangrenous sigmoid colon (34/46, 74%), while resection and stoma was performed in 8 patients with gangrenous colon. Death occurred in 7 (11.5%) patients due to severe sepsis and multisystem organ failure. Morbidities were noted in 15 (24.6%) patients, including surgical site infection (8, 13.1%), respiratory insufficiency (4, 6.6%), fascial dehiscence (3, 4.9%) and anastomotic leak (2, 3.2%). The mean duration of hospitalization was 8.3 days (range 1-26).<br />Conclusion: In this review, though retrospective in nature, ISK was noted to have high rates of bowel gangrene. In the appropriate setting, resection and primary anastomosis can be safely carried out in most cases of gangrenous colon.
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Colonic Diseases complications
Colonic Diseases epidemiology
Colonic Diseases surgery
Female
Gangrene pathology
Gangrene surgery
Hospitalization statistics & numerical data
Humans
Ileal Diseases complications
Ileal Diseases surgery
Intestinal Obstruction etiology
Intestinal Volvulus complications
Intestinal Volvulus surgery
Kenya epidemiology
Length of Stay
Male
Middle Aged
Retrospective Studies
Sigmoid Diseases complications
Sigmoid Diseases surgery
Young Adult
Gangrene epidemiology
Ileal Diseases epidemiology
Intestinal Volvulus epidemiology
Sigmoid Diseases epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1937-8688
- Volume :
- 23
- Database :
- MEDLINE
- Journal :
- The Pan African medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 27347287
- Full Text :
- https://doi.org/10.11604/pamj.2016.23.198.6255