The CT appearances of an unusual type of trichobezoar which causes the Rapunzel syndrome are described. This syndrome is characterized by intestinal obstruction secondary to a bezoar possessing a tail which extends to or beyond the ileo-cecal valve. Most cases of bezoar are diagnosed with plain films or barium meal, but CT may be requested in patients who present with abdominal masses. The Rapunzel syndrome may be diagnosed with a combination of the CT findings and the history.

PurposeTo compare the relationship between obesity markers Body Mass Index (BMI) and Back Fat Thickness (BFT) and oedema in the lumbo-sacral subcutaneous adipose tissue.Patients and methodsA retrospective study was performed of consecutive Magnetic Resonance Imaging examinations on 149 adults (95 females and 54 males) scanned at 1.5T between October 1 and December 31, 2010. The extent of oedema was graded from 1 to 8 based on the number of involved anatomical segments on the Fat Sat sequence. A vertebra and the disc immediately inferior or any of the upper, middle or lower third of the sacrum was assigned 1 unit. BFT was measured superiorly at the upper border of L1 (BFT L1) and inferiorly at the lower border of L5 (BFT L5) on the T1 weighted image. BMI was computed at the time of the examination. The data were analysed using StatPlus 2009. The association between variables was evaluated using univariate and multivariate regression.Results68 patients (45.6%), 50 females (33.6%) and 18 males (12.0%) were found to have oedema. Weight (p = 0), BMI (p < 0.001), BFT L1 (p < 0.001), BFT L5 (p < 0.001) and age (p = .01) were significantly associated with oedema. On forward stepwise multiple regression significant independent variables predicting oedema were found to be BMI, BFT L1 and Age. ANOVA indicated that BMI explained 23.6% (F = 45.5, p = 0), BFT L1 22.7% (F = 43.2, p = 0) and age 4.7% (F = 7.4, p = 0.007) of the variance of oedema.ConclusionsObesity markers BMI and BFT L1 are significant independent variables predicting oedema. Oedema is predicted to a variable extent by fat at different sites. The oedema may be, in part, a consequence of obesity.

Fifty consecutive micturating cystourethrograms (MCUG) performed at the UHWI between June 1989 and December 1991 were reviewed. There were forty boys and ten girls. Infants under the age of one year accounted for 58%. Urinary tract infection was the commonest presenting feature (72%), voiding difficulties (10%) and associated malformations (14%) were the other reasons for doing the MCUG. Only 10% of the children revealed vesico-ureteral reflux (VUR) which supports the view that reflux is less common in the noncaucasian population. In our population, the yield from MCUG is low. However, when detected, the reflux was of significant degree as to warrant active therapy. All but one of the VU refluxes diagnosed by MCUG had ultrasonographic abnormalities. Black children with single urinary infections have a low likelihood of VUR. A clear history of pyelonephritis and abnormalities on ultrasound or radionuclide cystogram may be used as criteria to select those in whom MCUG will be useful.