Ileo-ileal knotting causing gangrenous small bowel obstruction; a rare case report

Ileo-ileal knotting was first described by Riverius in the 16th century and by Rokitansky in 1836. It is one of the rare causes of acute abdominal pain which mandates urgent surgical treatment. Preoperative investigations are usually nonspecific and high index of suspicion. A 27-year- old male was admitted to Gondar University hospital with a preliminary diagnosis of intussusception and underwent emergency open laparotomy. Intraoperatively a small intestine gangrene caused by an ileo-ileal knot was found. Resection of the gangrenous segment followed by ileo-transverse colon anastomosis was done. Post- operative course was smooth and he was discharged improved. Ileo-ileal knot should be highlighted as a rare cause of acute small bowel obstruction. that necessitates immediate surgical intervention, particularly in resource limited setups, and complications should be considered in the perioperative period.