Ileosigmoid knotting occurs when the ileum wraps around the base of an elon
gated sigmoid colon, thus producing two closed-loop obstructions with the p
ossibility of ischemia and necrosis of either the ileum or sigmoid colon. I
t occurs more commonly in African, Asian, and Middle Eastern countries, alt
hough 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.