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Human Hairballs (Trichophagia; Trichobezoars; Rapunzel Syndrome)

TheQuixote

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Trichobezoar

This trichobezoar, or hairball, is one of three in the Museum's collections. This specimen was successfully removed during surgery from the stomach of a 12-year-old girl. From age six she had suffered from trichophagia, an emotional disorder causing young girls to eat their hair.

Trichobezoar

(how many women as young girls were told this would happen to you if you chewed or sucked the ends of your hair? I know I was lectured constantly) :cross eye
 
Rapunzel Syndrome can prove fatal ...

Teen Dies from 'Rapunzel Syndrome': Why Do People Eat Their Hair?
A 16-year-old girl in England died from an extremely rare condition called Rapunzel syndrome, according to news reports.

The teen lost consciousness on Sept. 7; she was taken to the hospital and died shortly after, the Independent reported Sept. 19.

Though the name is inspired by the fairy tale princess with incredibly long hair, Rapunzel syndrome does not have a happy ending. The condition occurs when a person has a hair ball in his or her stomach, and that hair ball has a "tail" that extends into the intestines. ...

The large mass of hair — called a "trichobezoar" — can cause digestive problems, such as nausea and vomiting, as described in one woman's case from September 2016.

In the teen's case, however, the hair ball ultimately caused a condition called peritonitis, or inflammation of the lining of the abdomen, according to Lincolnshire Live. This condition can lead to body-wide inflammation that causes organs to shut down.

It's possible that a trichobezoar could lead to an ulcer, or open sore, in the lining of the stomach, said Dr. Cathy Burnweit, chief of pediatric surgery at Nicklaus Children's Hospital in Miami, who was not involved in the teen's case. If the ulcer perforated the stomach, bacteria from the hair ball could spill into the abdominal cavity, causing an infection and inflammation, she said.

Burnweit has removed trichobezoars from patients. The large balls of hair form when a person ingests his or her hair over several years, and that hair builds up into a hard mass, Burnweit told Live Science. "You think about a hair ball as being spongy," but these are rock-hard and shaped like the stomach, she said.

Large trichobezoars can block a person's gastrointestinal tract, making it difficult for him or her to eat and leading to malnutrition, Burnweit said; they also cause bad breath.

The masses of hair need to be removed surgically, Burnweit said, and after surgery, patients typically need psychological treatment to address why they are eating their hair in the first place.

SOURCE: http://www.livescience.com/60471-rapunzel-syndrome-trichophagia.html
 
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Here's a 2016 case illustrating how debilitating the condition can be ...
'Rapunzel Syndrome' Caused Woman's Odd Symptoms

For one woman, the inability to keep any food down was caused by an incredibly rare condition called "Rapunzel syndrome," according to a new report of her case.

Named for the fairy tale princess with incredibly long hair, the extremely uncommon condition occurs when a person has a hairball in his or her stomach, and the hairball has a tail that extends into the intestines.

Rapunzel syndrome is caused by a psychiatric disorder in which people compulsively swallow their own hair, called trichophagia. Trichophagia is related to a slightly more common disorder in which people have an irresistible urge to pull out their hair, called trichotillomania. ...

The 38-year old woman went to the doctor after two days of nausea, vomiting and constipation, according to the report of her case, published today (Oct. 6) in the journal BMJ Case Reports. ...

She had been throwing up any food that she tried to eat, and her abdomen was protruding from her body, the doctors who treated her wrote in the report. In addition, the woman had lost about 15 lbs. (7 kilograms) over the previous eight months, and her appetite had significantly decreased over the previous year.

The doctors ran several tests, but none revealed the cause of her symptoms, according to the report. A blood test, however, did show that she had low levels of protein in her blood.

The doctors suspected that the woman's symptoms were likely being caused by something obstructing her digestive tract, and decided to operate.

They discovered a large hairball in her stomach measuring 6 x 4 inches (15 x 10 centimeters), with a short tail extending into the top part of her small intestine, according to the report. Further down in her small intestine, the doctors found another hairball, measuring 1 x 1.5 inches (4 x 3 cm), they wrote. ...

FULL STORY: https://www.livescience.com/56403-rapunzel-syndrome.html
 
Here's the latest reported case ...
Teen Has 3-Pound Hair Ball Removed from Her Stomach

A teen in India who secretly ate her own hair ended up having a giant hair ball removed from her stomach, according to news reports.

The 14-year-old went to the doctor with abdominal pain and vomiting, according to Fox News. Surprisingly, doctors found a 3-lb. (1.3 kilograms) hair ball wedged in her stomach.

The girl was diagnosed with Rapunzel syndrome, an extremely rare condition in which a hair ball in the stomach — known medically as a trichobezoar — extends into the intestine, Live Science previously reported. Only about 60 cases of Rapunzel syndrome have been reported in the medical literature since the condition was first recognized, in 1968, according to a 2018 paper on the condition published in the journal Pediatric Reports. ...

FULL STORY: https://www.livescience.com/giant-hairball-stomach-rapunzel-syndrome.html
 
Here's a newly published case from the UK, in which a 17-year-old girl ingested enough hair to create a cast of her distended stomach.

RapunzelSyndrome-2102.jpg

Giant hair ball tears through teen's stomach, requiring surgery

A teen in the U.K. who compulsively ate her own hair ended up developing a massive hair ball in her stomach that tore a hole through her stomach wall, according to a new report.

The oval-shaped hair ball was 19 inches (48 centimeters) long and completely filled her stomach, according to the report, published Feb. 9 in the journal BMJ Case Reports.

The 17-year-old initially went to the hospital after she fainted twice, bruising her face and scalp during the falls. ...

Doctors wanted to rule out a head injury, but during an exam, they also noticed a mass in the girl's upper abdomen. The teen said she had experienced intermittent abdominal pain for the past five months, which had worsened over the two weeks prior to her hospital visit, the report said.

She also had a history of two mental health disorders: trichotillomania, or a strong urge to pull out one's hair; and the related condition trichophagia, or the compulsive eating of hair.

A computed tomography (CT) scan revealed a "grossly distended stomach" with a large mass inside, and a tear in the stomach wall ...

The teen was diagnosed with Rapunzel syndrome, in which a hair ball in the stomach — known medically as a trichobezoar — extends into the intestine, Live Science previously reported.

She underwent surgery, and doctors removed the hair ball, which was so large it "formed a cast of the entire stomach" ...

FULL STORY: https://www.livescience.com/giant-hair-ball-tears-stomach-rapunzel-syndrome.html
 
Here are the bibliographic details and abstract for the published report on this latest case.

Jackman J, Nana GR, Catton J, et al
Gastric perforation secondary to Rapunzel syndrome
BMJ Case Reports CP 2021;14:e240100.
http://dx.doi.org/10.1136/bcr-2020-240100

Abstract
Rapunzel syndrome is rare and describes a trichobezoar that extends through the pylorus into the jejunum, ileum or even the colon. Due to the large intraluminal size and weight they can attain, acute presentations of obstruction or perforation may occur. We report a case of a 17-year-old girl who presented to the emergency department following a syncopal episode. On examination, a left upper quadrant mass was appreciated with no signs of peritonism. Contrast-enhanced CT demonstrated a giant trichobezoar with resulting gastric perforation and intra-abdominal free fluid. Laparotomy and gastrotomy were performed and the patient had an uneventful recovery with psychiatric review prior to discharge. Though uncommon, bezoars should be included in our differential diagnosis as they can present in various ways owing to their size and weight. This case illustrates the risk of gastric perforation with large gastric bezoars.

SOURCE: https://casereports.bmj.com/content/14/2/e240100
 
Ha! That's funny --a bit earlier today I was going nominate "Bezoar" for a word we should use more often, as in:
"That guy sure is a bezoar!" :cool:
 
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