A 16-year-old girl’s persistent gastrointestinal issues were recently traced to a surprising source: a massive hairball lodged in her stomach. This unusual case, a rare example of Rapunzel syndrome, highlights the potential dangers of this often-overlooked condition.
Doctors at Massachusetts General Hospital documented this medical anomaly in the New England Journal of Medicine. The girl initially presented with intermittent vomiting and stomach pain, which progressively worsened over four weeks. Two visits to a local emergency department failed to identify the cause, providing only temporary symptom relief. It wasn’t until she reached Mass General that the true culprit was revealed.
The girl’s persistent vomiting, coupled with the fluctuating intensity of her pain, led doctors to suspect a gastric outlet obstruction—a blockage between the stomach and small intestine. This type of obstruction is often caused by a bezoar, a mass of foreign material, frequently hair or fiber. To confirm their hypothesis, the medical team used a camera-equipped tube to explore her upper gastrointestinal tract.
The examination revealed a substantial trichobezoar (a hairball) residing in her stomach, with tendrils extending into the small intestine. Fortunately, the doctors were able to extract the hairball through the tube, avoiding the need for surgical intervention. The image of the extracted hairball, available in the NEJM article, vividly illustrates the severity of the blockage.
Human hairballs typically result from trichophagia, a disorder characterized by the compulsive swallowing of hair, often associated with trichotillomania (compulsive hair pulling). Although the girl denied engaging in these behaviors, it’s possible that shame or denial obscured the underlying cause. A month after the procedure, the girl reported complete relief from her stomach pain. While she declined a referral to a psychologist, she planned to consult a hypnotherapist.
This case underscores the importance of considering Rapunzel syndrome in patients presenting with unexplained gastrointestinal symptoms. Remarkably, this isn’t the only reported instance in 2024. Earlier in July, doctors in Ecuador removed a two-pound hairball from a woman’s stomach. These cases emphasize the need for awareness and prompt diagnosis of this rare but potentially serious condition.
This young girl’s experience highlights the diagnostic challenges and potential health risks associated with trichophagia and Rapunzel syndrome. Early intervention and appropriate medical care are crucial for successful treatment and recovery.
