“Rapunzel, Rapunzel, put that hair down!”
A 17-year-old woman from the UK is recovering well after doctors discovered a football and a half-length hairball literally tore through her stomach.
A new report in BMJ Case Reports describes the horrific circumstances of the teenager with a ‘Rapunzel’ syndrome, who forcibly devoured her own hair – enough to gather a hairball, in the clinical setting called a trichobezoar, which was 19 inches long and covered her entire abdomen, according to doctors at Queen’s Medical Center in Nottingham.
The patient was brought to the hospital after two mysterious fainting wounds that bruised her face. Doctors quickly ruled out that the head injury was to blame after noticing swelling in the woman’s upper abdomen. She also described alternating abdominal pain during the preceding five months, which worsened in the two weeks before hospitalization.
A CT scan reveals a large mass in her ‘coarsely stretched abdomen’ and a tear in the lining of the organ. At that point, the patient’s mental health struggle becomes apparent.
The teenager had a well-known history of trichotillomania, which is characterized by the urge to pull hair out, as well as trichophagia, which is the compulsive eating of hair.
Both conditions are rare, as only 0.5% and 3% of people experience trichotillomania; An estimated 10% to 30% of cases of trichotillomania are associated with trichophagia, LiveScience reported. And a study in Pancreas from 2019 noted that only 1% of those suffering from both disorders will develop a hairball in the digestive tract.
The hairy sample became so large that doctors after surgical removal discovered that the trichobezoar “formed a cast of the entire stomach,” they wrote.
The patient is happy: hairballs of this size were fatal – as with one 16-year-old girl from the UK in 2017, who died of Rapunzel syndrome after the trichobezoar caused a fatal infection.
After psychiatric evaluation and post-operative cure, the woman was released within only seven days after the procedure. After one month, doctors reported that she had “progressed well with dietary advice” and regularly went to a therapist.
