Ileosigmoid knotting: An update for atamanalp classification

Ileosigmoid knotting (ISK) is an extremely rare double-loop bowel obstruction. ISK is treated by emergency surgery with a relatively poor prognosis. Although some classification methods have been developed for ISK to date, the most comprehensive method was defined in 2018. Then, some subjects concerning this issue were evaluated in the literature. The aim of this paper is to update the last classification method in light of both the evaluations in the literature and our clinical experience with 80 ISK cases, which is one of the largest published single-centre ISK series.