1 Introduction
The causes of bowel obstruction may be external to the bowel (extrinsic), within the wall of the bowel (intrinsic), or due to a luminal defect that prevents the passage of gastrointestinal contents. Most common causes of small bowel obstruction are adhesions, hernias, small intestinal volvulus while large bowel obstruction is often caused by tumors and volvulus(1).
Advanced bowel obstruction leads to bowel dilation and retention of fluid within the lumen proximal to the obstruction, while distal to the obstruction, as luminal contents pass, the bowel decompresses. If bowel dilation is excessive, or strangulation occurs, perfusion to the intestine can be compromised, leading to necrosis or perforation, complications that increase the mortality associated with small bowel obstruction(1).
Various types of intestinal knot syndromes such as ileoileal knots, ileosigmoid knots and appendico-ileal knots do cause intestinal obstruction though very rarely(2). Even rarer causes are knotting of the ileum by meckel’s diverticum, ileocecal knotting and midgut volvulus(3–5). These could be due to failure in the last phase of rotation that is fixation of proximal and distal portions to the retro peritoneum. These can primarily cause volvulus because of narrow mesenteric base(6).
In these paper we present a 21 year old male Ethiopian patient who presented in a critical condition with sign and symptoms of small bowel obstruction but found to have ileocecal knotting with mobile cecum and ascending colon.