This study aimed to identify early predictors of poor prognosis in patients with strangulating ileus complicated by septic DIC.<h4>Methods</h4>We retrospectively analyzed 67 patients diagnosed with strangulating ileus at a single institution between 2020 and 2024, who subsequently developed septic DIC according to the Japanese Society for Emergency Medicine criteria and were treated with recombinant thrombomodulin (rTM). The gene discussed is THBD; the disease is ileus.