A unique surgical emergency: ileosigmoid knotting

Ileosigmoid knot (ISK) is a rare cause of bowel obstruction that leads to gangrenous bowel necrosis. In this condition, the ileum and sigmoid colon wrap around each other, causing a knot and strangulation of both structures. ISK is extremely rare in North America; most cases are reported in Asia and Africa. Furthermore, ISK typically presents in adults in their fourth decade or older. Here we present the rare case of an ISK in a 14-year-old male.