Doctors remove massive hairball from eight-year-old girl’s stomach

The girl underwent open surgery to remove the hairball as it was too large and sticky to be removed endoscopically. 
| Photo Credit: file photo

When their eight-year-old child had frequent vomiting and poor appetite, little did the parents realise that she was suffering from a rare medical condition.

Doctors at a private hospital where she was taken concluded that the girl was suffering from trichobezoar, a condition caused by trichophagia, the compulsive eating of hair also known as Rapunzel Syndrome. A team of doctors removed a massive hairball from her stomach, relieving her of the symptoms.

It started as an innocent habit. For two years, eight-year-old Aditi (name changed) from Bengaluru experienced intermittent bouts of poor appetite and frequent vomiting. Her parents, puzzled by her persistent symptoms, sought help from numerous doctors, but each diagnosis and treatment failed to bring relief.

Initial evaluations

Initial evaluations by paediatricians, general physicians, and ENT specialists suggested gastritis, and she was prescribed multivitamins. It was not until a month ago that the puzzle began to unravel when the girl was admitted to the Paediatric Emergency at Aster Women and Children Hospital, Whitefield, Bengaluru.

After examination, it was revealed that she had a trichobezoar, which is basically a hair mass stuck inside the gastrointestinal tract. This exceptional condition resulted from severe symptoms that are linked to trichophagia — compulsive eating of hair. A medical team comprising Manjiri Somashekhar, Lead and Senior Consultant – Paediatric Surgery, Sethu Mohan K, Senior Specialist – Pediatric Surgery and  Aravind A, Consultant – Paediatrics, addressed this complex case.

“Trichobezoar is an extremely rare condition and especially very rare in a child as young as Aditi. It is often associated with trichophagia, a psychological disorder where individuals eat hair. While commonly seen in adolescent girls, finding this in a much younger child is extraordinary and highlights the uniqueness of this case,” said Dr Manjiri Somashekhar.

Aditi underwent open surgery to remove the hairball as it was too large and sticky to be removed endoscopically. The surgical team decided on this approach to prevent spillage into the peritoneal cavity, a choice that proved effective. The surgery lasted two and a half hours, and Aditi was hospitalised for a week for postoperative care.

Malnutrition

“If left undiagnosed, this condition could have led to severe malnutrition, anaemia, and significant bleeding from the stomach. The hairball could have embedded into the stomach lining, causing severe bleeding during removal and potentially leading to life-threatening complications such as perforation,” said Dr. Mohan.

Following the surgery, Aditi was placed on a high-protein diet and partial parenteral nutrition (feeding intravenously) to address her malnutrition. She also received counselling to manage her trichophagia. A child psychologist is overseeing her mental health, with her family closely involved in the treatment plan.

The long-term prognosis for the child is positive, provided she continues to receive psychological support and regular monitoring. Preventive measures include educating parents about the signs of trichophagia, such as sparse hair in the frontal scalp area, and the importance of psychological assessment in conjunction with surgical treatment, according to a statement from the hospital.