Ileosigmoid Knotting (ISK) is a rare cause of acute intestinal obstruction involving ileum and sigmoid colon entanglement, classified into types I to IV and classes 1 to 6 based on mortality risk factors. Reversed rotation of the midgut, a rare malrotation anomaly, results from clockwise embryonic rotation, causing duodenal and transverse colon positional reversal. Clinical suspicion of midgut malrotation arises from obstruction symptoms, often requiring urgent surgical intervention in neonates and definitive care in adults.
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