Ileosigmoid knotting causing gangrenous bowel obstruction in a postpartal mother presented with septic shock: A case report and review of literature

Table 1 Laboratory results with reference ranges

Test (classification)	Patient result	Standard normal range
Complete blood count - WBC	13 × 103/μL (neutrophils 60%, lymphocytes 34%)	(4-10) × 103/μL (neutrophils 40%-70%, lymphocytes 20%-40%)
Hemoglobin	15.5 g/dL	13.5-17.5 g/dL (male); 12.0-15.5 g/dL (female)
Hematocrit	45%	41%-53% (male); 36%-46% (female)
Platelet count	253 × 103/μL	(150-400) × 103/μL
Renal function - blood urea nitrogen	58 mg/dL	7-20 mg/dL
Renal function - serum creatinine	1.37 mg/dL	0.7-1.3 mg/dL (male); 0.6-1.1 mg/dL (female)
Liver enzymes - AST	50 U/L	10-40 U/L
Liver enzymes - ALT	19 U/L	7-56 U/L
Serum albumin	3.4 g/dL	3.5-5.0 g/dL
Serum electrolytes - sodium	135.3 mmol/L	135-145 mmol/L
Serum electrolytes - potassium	3.63 mmol/L	3.5-5.0 mmol/L
Serum electrolytes - calcium	2.3 mmol/L	2.1-2.6 mmol/L
Serum electrolytes - chloride	107 mmol/L	98-106 mmol/L

WBC: White blood cell; AST: Aspartate transaminase; ALT: Alanine aminotransferase.

Table 2 Alver et al[19] classification (1993)

Type	Description	Frequency, %
Type I	Ileum (active component) wraps around the sigmoid colon (passive component). Type Ia - clockwise direction type Ib - anticlockwise direction	55
Type II	Sigmoid colon (active component) wraps around the ileum (passive component). Type IIa - clockwise direction type IIb - anticlockwise direction	25
Type III	Ileocecal segment (active component) wraps around the sigmoid colon (passive component)	5
Type IV	Undetermined - impossible to determine the revolved segment	15

Table 3 Atamanalp et al[20] classification (2009)

Class	Clinical criteria
Class 1	No risk factor
Class 2	No shock or gangrene but presence of other risk factors (e.g., age > 60 years or associated disease)
Class 3	Presence of shock
Class 4	Single-segment bowel gangrene (ileum or sigmoid colon)
Class 5	Shock and single-segment bowel gangrene
Class 6	Gangrene in both segments