The ileosigmoid knot (ISK) is a rare cause of intestinal obstruction. Unfamiliarity with the condition could have disastrous consequence at surgery. Over the past 20 years, we have encountered seven cases. Analyzing the data gathered from these, and on reviewing the literature, we found it possible to arrive at a preoperative diagnosis in two patients. Four patients were women, two of whom developed the obstruction in the postpartum period. One of the males was found to have an inflamed Meckel's diverticulum included in the knotting. The symptoms and the clinical findings were nonspecific. The characteristic x-ray findings of a double closed loop obstruction, was seen in only three patients. Resection of gangrenous bowel with anastomoses was feasible in four. Unlike in other series, primary anastomosis of the large gut was undertaken. There were two deaths early in the series. Guidelines to the management have been suggested.

A case of adenocarcinoma developing in the pouch following restorative proctocolectomy is presented. This seems to be the third reported in the literature. The carcinoma developed from the remnants of precancerous rectal mucosa left in the muscular rectal cuff. The patient had been suffering from ulcerative colitis for 17 years prior to the development of the malignancy. He presented with features of subacute intestinal obstruction. Diagnosis was by sigmoidoscopic examination of the pouch and biopsy. He was treated with abdominoperineal resection of the pouch and rectum, followed by chemotherapy.

Gastric pull-up is a reliable method of one-stage reconstruction following total laryngopharyngoesophagectomy (TLPE). However, the technique of blunt finger dissection for extrapleural extraction of the oesophagus is liable to produce chest complications like pneumothorax. We report a series of 45 patients who underwent gastric pull-up using the technique of oesophageal extraction by stripping which produced virtually no thoracic complications. This simple technique has greatly reduced morbidity associated with gastric pull-up.

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Summary CYLD cutaneous syndrome (CCS) is a rare inherited skin disease. This disease affects about 1 in every 100,000 people in the U.K. and is more severe in females. It causes the development of multiple, sometimes hundreds, of skin tumours in each patient; these skin tumours, called cylindromas, can be painful and may grow rapidly. Depending on where they grow they can also cause problems; for example, blockage of the ear canal affecting hearing, and pubic tumours causing sexual dysfunction. We showed for the first time, evidence of cylindromas in the lung in a mother and daughter with CCS. Samples of both patients’ lung and skin tumours were taken, and studied with pathologists, and investigated with cutting‐edge genetic tests. These genetic tests allowed us to demonstrate that the gene signature of the lung cylindromas were similar to the gene signature of skin cylindromas. This suggests that sometimes, cylindroma cells may travel from the skin to the lung. It is important that doctors looking after CCS patients are aware of this possibility and understand the need to investigate if patients with this condition present with new symptoms of lung disease. It also guides doctors regarding follow‐up with repeat scans for these patients and treatments such as laser to trim back these lung tumours if they are going to block the large airways in the lung.