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.