A Giant Trichobezoar Causing Rapunzel Syndrome in a 12-year-old Female.

Bezoar is a tightly packed collection of undigested material that is unable to exit the stomach. Most bezoars are of indigestible organic matter such as hair-trichobezoars; or vegetable and fruit-phytobezoars; or a combination of both. Trichobezoars commonly occur in patients with psychiatric disturbances who chew and swallow their own hair. In very rare cases, the Rapunzel syndrome hair extends through the pylorus into the small bowel causing symptom and sign of partial or complete gastric outlet obstruction. A case report of trichobezoar in the stomach causing Rapunzel syndrome in a 12-year-old female is reported.

Unusual metastasis to all the digits of both hands in a patient previously operated on for esophageal carcinoma.

Metastatic malignancies to the hand, although rare, usually develop from lung, breast, and kidney tumors. Very rarely the origin is the gastrointestinal system. Metastases to the bones of the hand can cause pain, swelling, soft tissue ulceration, and osteolytic destruction. We present a patient with metastatic tumors to all digits of both hands 2.5 years after being operated on for esophageal carcinoma. The patient underwent amputation of the left little finger followed by systemic chemotherapy. The histopathological diagnosis was consistent with that of the primary tumor. This case is being presented for being the rarest of its kind and may even be the first of its nature in the world's literature as an extensive search has not shown another of its kind to date.

Isolated gangrene of the penis in a paraplegic patient secondary to a condom catheter.

Isolated gangrene of the penis is rare. Our case was unusual in that gangrene developed due to continuous tourniquet effect on the penis caused by a condom catheter. Also, men with paraplegia appear to have a greater incidence of bacterial colonisation of genital skin as compared to neurologically normal controls. Early therapy is the key, including debridement of entire shaft of the penis distal to the devasted area, parenteral broad-spectrum antibiotics, repeated antiseptic dressings and skin grafting. Early diagnosis by a strong index of suspicion ensures a favourable outcome. Since gangrene of the penis is an irreversible process, this case highlights the importance of proper care and routine maintenance of condom catheters in preventing this complication. Despite extensive search of the literature, I have been able to find only few such cases.