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Doctors at Manipal Hospital Dwarka in Delhi successfully removed a giant 1.16-kg, J-shaped hairball from the stomach of a 20-year-old female student who had been consuming strands of her own hair for nearly 11 years, a behaviour medically known as trichophagia.
According to a press release, the rare trichobezoar -- a compact mass of swallowed hair -- had occupied a major portion of the patient's stomach and extended from the junction of the food pipe and stomach to the beginning of the small intestine. The condition caused severe gastric distension and required a multi-step approach for complete removal. The patient was brought to the hospital after experiencing 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. An upper gastrointestinal endoscopy subsequently confirmed the presence of a large trichobezoar occupying much of the stomach. Since hair cannot be digested, it can gradually accumulate in the stomach, trapping food and forming a dense mass over time. In this case, the hairball had grown to such an extent that it stretched from the junction of the food pipe and stomach to the opening leading into the small intestine. Speaking about the case, Dr (Prof) Sandeep Aggarwal, Chairman, Manipal Institute of Minimal Access, Bariatric, GI & Robotic Surgery, Manipal Hospital Dwarka, said, Trichobezoars can remain undetected for years because patients may not always recognise hair-eating as a medical concern or may not disclose it during routine consultations. In this case, the large size and density of the mass made its removal particularly challenging. 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, he said in a press release. 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. So, a small abdominal incision was used to safely release the mass from the stomach lining and extract the mass in its entirety, Dr Aggarwal added. Following the surgery, the patient's symptoms improved significantly, with her appetite and ability to tolerate food gradually returning. She subsequently gained weight and returned to her studies. Doctors said the case highlights the importance of recognising persistent gastrointestinal symptoms and unusual eating behaviours at an early stage. Alongside surgical treatment, early recognition of trichophagia and appropriate psychological support are important to address the underlying behaviour, prevent recurrence and support long-term recovery. Manipal Hospital said it remains committed to providing multidisciplinary care for complex cases by combining minimally invasive surgical expertise with appropriate psychological support to improve patients' quality of life. (ANI)
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