Factors triggering knot formation in ileosigmoid knotting

OBJECTIVES: Ileosigmoid knotting (ISK) is a rare double-loop ileus form. Therefore, its physiopathology including the triggering factors, are not well investigated. We aimed to discuss the physiopathology, particularly the triggering factors in ISK. METHODS: The data of 80 patients with ISK were analyzed retrospectively until June 1986 and prospectively thereafter. As control group, the data of 80 patients with bowel obstruction arising from adhesive ileus or strangulated inguinal hernia were evaluated prospectively during the last 24 months. As probable triggering factors in ISK, the role of acute diarrhea, body motions, overeating, coughing, and labor were investigated. RESULTS: Prior to the main clinical features of ISK, acute diarrhea (17 patients, 21.3%, p<0.05), harvesting (9 patients, 11.3%, p<0.05), and overeating (8 patients, 10.0%, p<0.05) were found effective. CONCLUSION: Although there is not enough data on this subject in the literature, increased bowel motility, excessive body motions, and overeating appear as the triggering factors in the forming of ISK.