Surgeons take away 2.5-inch hairball from teen with uncommon Rapunzel syndrome
Hair is immune to digestion and is not simply moved via the digestive system. As such, it usually will get lodged in folds of the gastric lining, denatures, after which traps meals and gunk to type 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 might be indistinguishable from meals within the abdomen until there’s an oral distinction materials. To search for a attainable bezoar within the teen, her docs ordered an esophagogastroduodenoscopy, during which a scope is put down into the abdomen via the mouth. With that, they received a transparent shot of the issue: a trichobezoar. (The picture is right 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 an especially unusual situation referred to as Rapunzel syndrome, named after the fairy-tale character who lets down her lengthy hair. It carries a number of problems past acute stomach ache, together with perforation of the abdomen and intestines, and acute pancreatitis. The one decision is surgical elimination. 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 vast, together with the dangling hair that reached into the small gut.
For any affected person with a trichobezoar, crucial subsequent step is to handle any psychiatric problems which may underlie hair-eating habits. Hair consuming is commonly linked to a situation referred to as trichotillomania, a repetitive habits dysfunction marked by hair pulling. Generally, the dysfunction might be recognized by indicators of hair loss—bald patches, irritated scalp areas, or hair at completely different development levels. However, for essentially the most half, it is an especially tough situation to diagnose as sufferers have substantial disgrace and embarrassment in regards to the situation and can usually 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 docs had been skeptical that pica might clarify her situation provided that hair was the one nonfood materials within the bezoar.
The teenager’s docs would have favored to resolve 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 advised her docs she would as a substitute see a hypnotherapist that her associates really useful.
