Ileosigmoid Knotting - Double Volvulus (Alver Type 4): A Rare Case Report

Abstract

Ileosigmoid knot is a rare cause of intestinal  obstruction. It is also called as compound volvulus or double volvulus. In this condition ileum forms a loop around sigmoid colon and passes beneath itself creating a knot. The incidence of ileosigmoid knot is not well known.  It is important to diagnose a case of ileosigmoid knot early because it  will rapidly progress to a double loop gangrene. Pre operative CT scanning is useful for the diagnosis of the condition and shows signs of intestinal obstruction. The mean mortality  for the condition is 6.8-8% in non gangrenous and      20-100%  in gangrenous cases. The following is a case report of a  42 year old male patient describing the presentation, diagnosis and management of ileosigmoid knotting alver  type 4 (compound volvulus).