{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:39:07Z","timestamp":1787593147636,"version":"build-2736575974"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Intestinal knot formation, in which two segments of the intestine become knotted together, can result in intestinal obstruction. An ileo-ileal knot refers to knot formation between two ileal segments and is a very rare benign disease. We report a case of strangulated bowel obstruction caused by true ileo-ileal knot formation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>An 89-year-old woman was referred to our hospital with the diagnosis of intestinal obstruction. Contrast-enhanced computed tomography revealed the small bowel forming a closed loop, with poor contrast effect. Based on the findings, the patient was diagnosed as having strangulated bowel obstruction, and emergency surgery was performed. At laparotomy, two segments of the ileum were found to be tied together forming a knot, and both segments were necrotic. Although it was necessary to release the strangulated small bowel, we did not immediately release the knot, but first proceeded with ligation of the mesenteric vessels to the strangulated small bowel to prevent dissemination of toxic substances from the necrotic bowel into the systemic circulation. The surgery was completed with resection of the necrotic ileum and anastomosis of the small intestine. The postoperative course was uneventful, and the patient was discharged home.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We encountered a case of strangulated bowel obstruction caused by true ileo-ileal knot formation. Resection of the necrotic small intestine without releasing the knot could be performed safely, and might be considered as an option of surgical procedure.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-021-01276-7","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T18:02:59Z","timestamp":1630000979000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Small bowel obstruction caused by a true ileo-ileal knot: a rare case successfully treated by prior ligation of mesenteric vessels"],"prefix":"10.1186","volume":"7","author":[{"given":"Kohei","family":"Kanamori","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8010-8630","authenticated-orcid":false,"given":"Kazuo","family":"Koyanagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Hara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhito","family":"Nabeshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamato","family":"Ninomiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Yatabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Ogimi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Tajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichiro","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Nakagohri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soji","family":"Ozawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"1276_CR1","first-page":"109","volume":"79","author":"K Taniguchi","year":"2017","unstructured":"Taniguchi K, Iida R, Watanabe T, Nitta M, Tomioka M, Uchiyama K, et al. Ileo-ileal knot: a rare case of acute strangulated intestinal obstruction. Nagoya J Med Sci. 2017;79:109\u201313.","journal-title":"Nagoya J Med Sci"},{"issue":"552","key":"1276_CR2","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1136\/bmj.2.552.119","volume":"2","author":"MW Taylor","year":"1871","unstructured":"Taylor MW. Intestinal obstruction from a knot on the lower part of the ileum. Br Med J. 1871;2(552):119\u201321.","journal-title":"Br Med J"},{"key":"1276_CR3","first-page":"1929","volume":"46","author":"T Kusaka","year":"1990","unstructured":"Kusaka T, et al. A successfully trated case of ileus due to knotting of the small intestine (in Japanese). J Clin Surg. 1990;46:1929\u201332.","journal-title":"J Clin Surg"},{"key":"1276_CR4","first-page":"117","volume":"48","author":"S Kondo","year":"1993","unstructured":"Kondo S, et al. Intestinal knotting: a clinical study of 7 cases (in Japanese). J Clin Surg. 1993;48:117\u201320.","journal-title":"J Clin Surg"},{"key":"1276_CR5","doi-asserted-by":"publisher","first-page":"28","DOI":"10.5348\/ijcri-2012-05-121-CR-6","volume":"3","author":"S Uday","year":"2012","unstructured":"Uday S, Venkata PKC, Bhargav P, Kumar S. Ileo-ileal knot causing small bowel gangrene: an unusual presentation. Int J Case Rep Imag. 2012;3:28\u201330.","journal-title":"Int J Case Rep Imag"},{"key":"1276_CR6","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1186\/1752-1947-8-200","volume":"8","author":"N Andromanakos","year":"2014","unstructured":"Andromanakos N, Filippou D, Pinis S, Kostakis A. An unusual synchronous ileosigmoid and ileoileal knotting: a case report. J Med Case Rep. 2014;8:200.","journal-title":"J Med Case Rep"},{"key":"1276_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ijscr.2015.01.015","volume":"8","author":"E Abebe","year":"2015","unstructured":"Abebe E, Asmare B, Addise A. Ileo-ileal knotting as an uncommon cause of acute intestinal obstruction. J Surg Case Rep. 2015;8:1\u20132.","journal-title":"J Surg Case Rep"},{"key":"1276_CR8","first-page":"1069","volume":"36","author":"J Uemura","year":"2016","unstructured":"Uemura J, Okano K, Wakabayashi A, Noge S, Asano E, Usuki H, et al. A surgical case of intestinal knot syndrome (true knot) (in Japanese). J Jpn Surg Assoc. 2016;36:1069\u201372.","journal-title":"J Jpn Surg Assoc"},{"key":"1276_CR9","first-page":"819","volume":"37","author":"S Matsuoka","year":"2017","unstructured":"Matsuoka S, Fujita K, Kikunaga H, Miura H, Kumai K. A case of bowel strangulation caused by an ileo-ileal knot (in Japanese). J Abdom Emerg Med. 2017;37:819\u201322.","journal-title":"J Abdom Emerg Med"},{"key":"1276_CR10","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1111\/ans.14793","volume":"89","author":"A Rajesh","year":"2019","unstructured":"Rajesh A, Rengan V, Anandaraja S, Pandyaraj A. Ileo-ileal knot: a rare cause of acute intestinal obstruction. ANZ J Surg. 2019;89:1661\u20133.","journal-title":"ANZ J Surg"},{"key":"1276_CR11","doi-asserted-by":"publisher","first-page":"519","DOI":"10.3919\/jjsa.76.519","volume":"76","author":"F Matsuzawa","year":"2015","unstructured":"Matsuzawa F, Hamaguchi J, Abe H, Suzuki T, Einama T, Kyuno K. Ileo-ileal knot causing strangulation ileus (in Japanese). J Jpn Surg Assoc. 2015;76:519\u201324.","journal-title":"J Jpn Surg Assoc"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-021-01276-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-021-01276-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-021-01276-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T18:04:19Z","timestamp":1630001059000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-021-01276-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,26]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1276"],"URL":"https:\/\/doi.org\/10.1186\/s40792-021-01276-7","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,26]]},"assertion":[{"value":"16 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in accordance with the principles of the Declaration of Helsinki. Ethics approval was waived by Institutional Review Board for Clinical Research, Tokai University.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate."}},{"value":"Written informed consent was obtained from the patient for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"195"}}