The rapunzel syndrome: report of a case and review of the literature

The Rapunzel Syndrome, a rare manifestation of trichobezoar, occurs when bolus gastrointestinal obstruction is produced by an unusual trichobezoar with a long tail that extends to or beyond the ileocaecal valve. A five-year-old Jamaican girl presented with this abnormality and was found at laparotomy also to have an ileo-ileal intussuception. For the Rapunzel Syndrome, we recommended bezoar extraction at laparotomy via multiple enterotomies. In addition, psychiatric evaluation and therapy is essential due to the commonly associated finding of underlying emotional stress. (AU)

Chondrolysis following slipped capital femoral epiphysis in Jamaica

We reviewed the cases of all patients with slipped capital femoral epiphysis at the University Hospital of the West Indies. Forty-seven hips in thirty-six Black patients were evaluated, and in 40 per cent of those hip chondrolysis developed. The appearance of roentgenographic changes of chondrolysis was predictable. There was a high percentage occuring within one year of diagnosis of slipped epihysis and within six months of closure of the proximal femoral growth plate. The persistent absence of motion in all planes following slipping of the capital femoral epiphysis was a constant finding in patients with chondolysis. This loss of motion can be diagnostic of impending chondrolysis and is usually present before the appearance of the roentgenographic changes. The microscopic changes suggest that the primary lesion is not necrosis of cartilage but a replacement of articular cartilage by pannus formation (Summary)