Upon arrival to the hospital, this 17-year-old girl passed out not once, but twice due to fainting spells. As a result of these falls, she had bruises on her face and scalp. What doctors discovered next, however, will truly shock you.
The physicians investigated her for a head injury when they went to see her. They discovered a mass in the girl’s upper abdomen during her checkup.
The teen had been feeling abdominal pain on and off for the past five months, but it got worse in the two weeks before she went to the hospital. She also previously suffered from trichotillomania and trichophagia, which are both mental health disorders.
Trichotillomania is a form of hair pulling that is characterized by an overwhelming urge to pluck one’s hair out, whereas Trichophagia is a type of eating disorder in which the afflicted person compulsively eats his or her hair.
According to the computed tomography (CT) scan, there was a large mass inside a “grossly distended stomach” with a tear in the stomach wall. The teen was diagnosed with “Rapunzel syndrome,” which is when hairball extends into the intestine from the stomach.
After the girl had surgery, doctors successfully removed the hairball. It was so large that it “formed a cast of the entire stomach.”
Following her surgery, the teen was taken to the ICU and given food through a feeding tube that had been inserted into her small intestine–this was necessary because her stomach needed time to heal.
The hospital psychiatrists proved an “uneventful postoperative course” seven days after the operation, and the girl was allowed to go home. Then a month later, she had no indications of issues. She “was progressing well with dietary advice,” as well as seeing a psychologist.
This isn’t the first time that a Rapunzel syndrome has occurred. A 38-year-old woman had a 15 x 10 cm hairball surgically removed from her stomach. Not only that, but a 4 x 3 cm hairball was also removed from the top of her small intestine.
Rapunzel syndrome, while exceedingly rare, is a real medical condition. In fact, there have been 89 reported cases in the BMJ Case Reports journal alone. The woman went to the doctor complaining of abdominal pain, nausea and vomiting – all symptoms which are associated with Rapunzel syndrome.
Common symptoms of Rapunzel Syndrome include a bloated stomach, reduced appetite, weight loss, and constipation or diarrhea. In some cases however, the bowel is punctured which can lead to sepsis or blood infection. Death has unfortunately occurred in 4% of these cases; example being a 16-year-old girl from England who died in 2017 because of a hairball infecting her stomach.
Eating hair can be harmful. It might block the intestines and lead to death. However, according to the National Organization for Rare Disorders, Trichotillomania is a disorder that affects 0.5% to 3% of people at some time in their life. Only 10% to 30% of persons with trichotillomania will also develop trichophagia, according to statistics from the National Hair Loss Association (NHA). And less than 1% of those who have both disorders develop masses of hair in their gastrointestinal tract.
The majority of patients with Rapunzel syndrome are females aged 20 or younger, according to reports. The youngest patient reported was a toddler, while the oldest was a 55-year-old man.