Small bowel obstruction (SBO) is one of the most common acute surgical conditions that require urgent evaluation and treatment. Several common causes are known in the general surgical practice, and the causes are different in the developing and developed world. In this article, we present a case of an acute SBO secondary to ileo-ileal knotting in a 50 years old Ethiopian female patient. The diagnostic difficulty and the need for urgent treatment of the condition are discussed.
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