POOR OUTCOMES OF ILEOSIGMOID KNOTTING AND ASSOCIATED FACTORS AMONG ADULT PATIENTS OPERATED AT WOLKITE UNIVERSITY COMPREHENSIVE SPECIALIZED HOSPITAL: A CROSS-SECTIONAL STUDY (JANUARY1, 2020 – DECEMBER 31, 2025)

Abstract

introduction Ileosigmoid knotting (ISK) is a rare but unique life-threatening surgical emergency in which a loop of the ileum and the sigmoid colon wrap around each other. The aim of this study was to evaluate poor outcomes and associated factors among adult patients operated for ISK. Methods This is institution-based cross-sectional study conducted at Wolkite University Comprehensive Specialized Hospital in Wolkite, Central Ethiopia. The study reviewed medical records over a six-year period, from January 1, 2020, to December 31, 2025, and included 54 adult patients who underwent surgery for ileosigmoid knotting. Secondary data were extracted from patient medical records and analyzed using SPSS version 27. A p-value of <0.05 was considered statistically significant. ResultsOf the 54 patients, 50 (92.5%) had complete medical records and were included in the analysis. Poor postoperative outcomes occurred in 23 patients, giving a proportion of 46%(95% CI: 31.8%–60.7%). Age (AOR=2.05, 95% CI: 1.03–4.07), bowel gangrene (AOR=3.84,95% CI: 1.46–10.10), preoperative shock (AOR=4.34, 95% CI: 1.48–12.69), and prolonged duration of symptoms (AOR=11.03, 95% CI: 2.69–45.20) were independently associated withpoor postoperative outcome. Conclusions and recommendations Nearly half of the participants had poor postoperative outcome. It is associated with advance age, delayed presentation, preoperative shock, and presence of bowel gangrene. Early recognition, prompt surgical intervention, and aggressive perioperative optimization, and stoma creation in double bowel gangrene are essential to improve outcomes.