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A new classification for ileosigmoid knotting

Aim: This study aimed to establish a new classification that will contribute to the treatment and prognosis of ileosigmoid knotting (ISK), which is a combination of ileum volvulus and sigmoid volvulus (SV). Materials and methods: Based on the SV classification in which criteria associated with mortality, such as age over 60 years and the presence of accompanying disease and/or shock, were used, and a new classification was made for ISK. For this classification, the records of 71 patients with ISK, who were treated surgically, were reviewed retrospectively, and unlike in SV classification, rather than the presence of sigmoid gangrene alone, the presence of both ileum and sigmoid gangrenes was used in the new classification. Results: In this series, 15 (21.1%) of 71 patients with ISK died. In this study, mortality was significantly correlated with ileum and/or sigmoid gangrene (P < 0.05). A new classification based on SV classification in which criteria associated with mortality, such as age over 60 years and the presence of accompanying disease and/or shock, were used, was made for ISK. Conclusions: Based on the evaluation of 71 patients with ISK according to the new classification, our clinical experience, and relevant literature, treatment options were suggested for each class, and potential mortality rates were determined. We believe that this new classification will be useful in determination of the treatment and prognosis of ISK.