There are almost no randomised controlled studies. According to the grading system of Oxford Center for Evidence Based Medicine (CEVM), available published evidence is at level 4. The recommendations resulting form this review are of 'C' grade.

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Correct preoperative diagnosis of ileosigmoid knot is possible when clinical, radiologic, and sigmoidoscopic features are considered together. Unraveling of the knot seems to be beneficial in ileosigmoid knot except when both components of the knot are frankly gangrenous. Primary anastomosis (ileoileal and/or colocolic) of resected gut seems to be a safe and better alternative in the management of ileosigmoid knot.

Nearly 28% of pediatric Spigelian hernias reported in the literature are associated with ipsilateral cryptorchidism. However, the pathogenetic relationship between the two has not been satisfactorily explained in the past. This paper describes a male neonate born with cryptorchidism and imperforate anus. Anal stenosis following the treatment of imperforate anus had let to the development of multiple hernias including Spigelian hernia on the right side. Surgical exploration revealed the right testis being located within the Spigelian hernia. Based on the sequence of events, it is hypothesized that Spigelian hernia in this case is a sequela of maldescended testis and raised intraabdominal pressure. As this explanation is also applicable to all of the previously reported cases, the author suggests that the combination of Spigelian hernia and ipsilateral cryptorchidism could probably form a hitherto unrecognized new syndrome.

One-stage restorative resection without on-table lavage or caecostomy appears to be a promising alternative in the emergency management of acute sigmoid volvulus. Comparison of primary anastomosis in gangrenous vs. viable colon did not reveal any significant difference in hospital stay, rate of anastomotic leak or mortality. However, the risk of wound infection was more in patients with gangrenous sigmoid volvulus.