Ileosigmoid knotting (ISK) is a rare cause of intestinal obstruction that rapidly progresses to gangrene of the ileum as well as the sigmoid colon. Even the surgery textbooks, such as Bailey & Love’s Short Practice of Surgery and Shackelford’s Surgery of the Alimentary Tract, give only a brief description of ISK. It is essential to differentiate it from sigmoid volvulus because endoscopic reduction may be possible in sigmoid volvulus, but not in ISK.
After hemodynamic stabilization, immediate surgical intervention is the only viable option. Considering the above, why a preoperative diagnosis of ISK is difficult?
