A teen complaining about intense stomach pain was diagnosed with an extremely rare condition, reported in only 50 cases to date, after surgeons found a bundle of hair in her digestive tract.
In a case study published in the New England Journal of Medicine on Wednesday, doctors recounted how a 16-year-old arrived at the Massachusetts General Hospital complaining about severe abdominal pain, nausea, and active vomiting. A few weeks earlier, she went to another hospital and reported about the same symptoms. A series of tests showed no problems so she was prescribed pain medications and was sent home.
However, over the next weeks, the pain became more severe, more frequent, and lasted longer. At Mass General, she was found to have an elevated heart rate and a tender stomach, but other vitals were otherwise normal.
Doctors were able to dismiss the more common conditions related to her symptoms but figured an obstruction in her gastrointestinal tract may be the cause. A bezoar is a mass of undigested or partially-digested material that accumulates in the digestive tract, Healthline explained.
After performing an esophagogastroduodenoscopy, the doctors found a 2.5-inch trichobezoar or a hairball. This is the most common bezoars in humans, however, for the teen, hers extended down into her small intestine--a very rare case. This condition is called Rapunzel Syndrome and has less than 50 reported cases in the world to date.
Rapunzel Syndrome, getting its name from the fairytale character known to let down her long hair, is a form of trichobezoar found in patients with a possible history of psychiatric disorder and a habit of hair pulling and chewing, the National Library of Medicine pointed out.
The teen underwent surgery and the hairball was successfully removed. However, doctors pointed out that addressing the underlying mental disorder is crucial to stop the reoccurrence of the condition.
"Once a bezoar is removed, the most important aspect of clinical management is to prevent the recurrence of the bezoar by addressing coexisting psychiatric disorders," Dr. Maureen M. Leonard, one of the study's authors, explained.
A month after the surgery, the teen's incision healed as expected. She also decided to visit a hypnotherapist for the disorder.
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