Surgeons remove 2.5-inch hairball from teen with rare Rapunzel syndrome

Hair is immune to digestion and is not simply moved by way of the digestive system. As such, it typically will get lodged in folds of the gastric lining, denatures, after which traps meals and gunk to kind a mass. Over time, it’ll proceed to gather materials, rising right into a thick, matted wad.

Of all of the bezoars, trichobezoars are the commonest. However none of them are notably straightforward to identify. On CT scans, bezoars may be indistinguishable from meals within the abdomen except there’s an oral distinction materials. To search for a potential bezoar within the teen, her medical doctors ordered an esophagogastroduodenoscopy, during which a scope is put down into the abdomen by way of the mouth. With that, they received a transparent shot of the issue: a trichobezoar. (The picture is here, however a warning: it is graphic).

Tangled tail

However this trichobezoar was notably uncommon; hair from the mottled mat had dangled down from the abdomen and into the small bowel, which is a particularly unusual situation referred to as Rapunzel syndrome, named after the fairy-tale character who lets down her lengthy hair. It carries a bunch of issues past acute stomach ache, together with perforation of the abdomen and intestines, and acute pancreatitis. The one decision is surgical removing. Within the teen’s case, the trichobezoar got here out throughout surgical procedure utilizing a gastrostomy tube. Surgeons recovered a hairball about 2.5 inches broad, together with the dangling hair that reached into the small gut.

For any affected person with a trichobezoar, an important subsequent step is to handle any psychiatric problems which may underlie hair-eating habits. Hair consuming is usually linked to a situation referred to as trichotillomania, a repetitive habits dysfunction marked by hair pulling. Typically, the dysfunction may be identified by indicators of hair loss—bald patches, irritated scalp areas, or hair at completely different progress phases. However, for essentially the most half, it is a particularly troublesome situation to diagnose as sufferers have substantial disgrace and embarrassment in regards to the situation and can typically go to nice lengths to cover it.

One other risk is that the teenager had pica, a dysfunction marked by persistent consuming of nonfood, nonnutritive substances. Intriguingly, the teenager famous that she had pica as a toddler. However medical doctors had been skeptical that pica might clarify her situation on condition that hair was the one nonfood materials within the bezoar.

The teenager’s medical doctors would have favored to unravel her situation and referred her to a psychiatrist after she efficiently recovered from surgical procedure. However sadly, she didn’t return for follow-up care and instructed her medical doctors she would as a substitute see a hypnotherapist that her mates advisable.