Essid NADA, Kerkeni ANIS, Ben Jemaa ILEF
Journal of Emergency Medicine Case Reports - 2026;17(2):83-85
Ileosigmoid knotting (ISK) is a rare and potentially life-threatening form of intestinal obstruction. We describe a 47-year-old patient from Tunisia, the second documented case nationally, presenting with acute abdominal pain and vomiting initially attributed to adhesive small bowel obstruction. Limited imaging resources in local hospital necessitated transfer to another facility, delaying surgical intervention. Exploratory laparotomy revealed a non-viable ISK, which was resected. This case highlights key teaching points: Rare causes of obstruction must be considered in patients with prior abdominal surgery, clinical vigilance is critical when imaging is limited, and timely transfer to tertiary centers can improve patient outcomes. Emergency clinicians must act decisively despite infrastructural constraints to prevent ischemic complications.
