Double ileo-sigmoid volvulus: Report of three (03) cases of ileo-sigmoid node

Int J Surg Case Rep. 2024 Oct:123:110231. doi: 10.1016/j.ijscr.2024.110231. Epub 2024 Sep 3.

Abstract

Introduction: The ileo-sigmoid node is a rare condition that causes mixed intestinal obstruction. It is difficult to diagnose preoperatively and requires medical and surgical management. We report on managing 03 cases of the ileo-sigmoid node.

Case presentation: 02 male patients (25 and 37 years old) and one female patient (43 years old) were seen in emergency for occlusive syndromes. The abdominal X-rays in our patients showed air-fluid levels of the small intestine type in two cases and of the mixed type in one case. The diagnosis of intestinal obstruction by strangulation was accepted in all three patients. Hypovolaemic shock was found in the female patient. All three patients had received preoperative resuscitation. Laparotomy revealed type II ileo-sigmoid nodes in 02 cases and type I in one. We noted ileal and sigmoid necrosis in 02 cases and ileal necrosis in 01 case. All three patients underwent ileal and sigmoid resection followed by colorectal anastomosis and terminal ileostomy. Post-operative management was straightforward in all the 03 cases.

Clinical discussion: The ileo-sigmoid node is a serious pathological situation, with the risk of rapid evolution of the intestines involved. It is a medical and surgical emergency requiring rapid and appropriate treatment.

Conclusion: The ileo-sigmoid node is a serious condition with a complex preoperative diagnosis. It is a medical and surgical emergency requiring rapid and appropriate management.

Keywords: Ileum; Node; Occlusion; Sigmoid; Volvulus.