Ileosigmoid knotting in a 6-year-old child.

Ileosigmoid knotting occurs when the ileum wraps around the base of an elongated sigmoid colon, thus producing two closed-loop obstructions with the possibility of ischemia and necrosis of either the ileum or sigmoid colon. It occurs more commonly in African, Asian, and Middle Eastern countries, although there have been three Americans previously reported with this problem. The 6-year-old child presented here is the youngest person ever reported with ileosigmoid knotting.