20-year-old gets 1.16-kg hairball removed
Eleven years of swallowing her own hair left a 20-year-old woman with a massive 1.16-kg hairball filling her stomach, which doctors at a private hospital here removed after she developed severe abdominal pain and repeated vomiting.
The woman, a student, had been consuming strands of her own hair since she was around nine years old, a behaviour medically known as trichophagia, doctors said.
She was brought to Manipal Hospital Dwarka after suffering severe abdominal pain, nausea and repeated vomiting for three days. She also had a longer history of poor appetite, weight loss and fatigue.
On examination, doctors found a hard lump in her upper abdomen, prompting further investigations. An upper gastrointestinal endoscopy confirmed a large trichobezoar, a compact mass formed from swallowed hair, occupying a substantial portion of the stomach.
The hairball had taken a J-shaped form and extended from the junction of the food pipe and stomach to the beginning of the small intestine, the doctors said. It had caused severe gastric distension and left very little space inside the stomach for manipulation.
Hair cannot be digested and, when repeatedly swallowed, can accumulate in the stomach. Over time, it can trap food and other material and become a dense mass.
In this case, the size and density of the hairball made its removal particularly challenging. Doctors initially attempted to fragment it using an endoscope, but were unable to remove the entire mass through the procedure.
"Initially endoscopic fragmentation was attempted, but given the extent of the mass, it could not be removed completely through the endoscope. We therefore proceeded with laparoscopic guidance to plan our surgical approach," said Dr Sandeep Aggarwal, Chairman, Manipal Institute of Minimal Access, Bariatric, GI and Robotic Surgery, Manipal Hospital Dwarka.
"The stomach was completely packed with this huge trichobezoar and there was hardly any space for manipulation of the mass. The situation was quite complex because there was a risk of injury to the stomach lining," he said.
The surgical team then used laparoscopic guidance and made a small abdominal incision to safely release the hairball from the stomach lining and extract it in its entirety.
The removed mass weighed 1.16 kg.
Doctors said the case was particularly unusual because the hairball had extended through the stomach from the food pipe-stomach junction to the opening leading into the small intestine.
Following surgery, the woman's symptoms improved significantly. Her appetite and ability to tolerate food gradually returned, and she subsequently gained weight and resumed her studies, doctors said.
Doctors said trichobezoars can remain undetected for years because people who consume their own hair may not recognise the behaviour as a medical concern or may not disclose it during routine consultations.
They said persistent abdominal symptoms, poor appetite, unexplained weight loss and a palpable abdominal mass should prompt doctors to consider the possibility of a bezoar, particularly when there is a history of hair-eating.
Doctors also stressed that removing the hairball treats the immediate physical complication but does not address the underlying behaviour. Early recognition of trichophagia and appropriate psychological support are therefore important to reduce the risk of the condition recurring, they said.
The case highlights the need for timely medical evaluation of persistent gastrointestinal symptoms and recognition of unusual eating behaviours, doctors said.
