Large ball of hair removed from stomach of five-year-old with extremely rare condition

The kindergarten pupil was undergoing a routine examination at a clinic when doctors found a blockage in the girl’s small intestine

Doctors at NMC Royal Hospital in Dubai Investment Park successfully removed a large ball of hair measuring 20cm long and 4cm thick from a five-year-old girl’s stomach.

The case was discovered on October 15, when Diya Rajesh, a kindergarten pupil, was undergoing a routine examination at a clinic for severe stomach pain accompanied by vomiting. Her parents thought it was a bout of gastritis, and consulted a doctor at International City.

However, the case turned out to be more complex. Diya was suggested to undergo a scan at NMC’s emergency department and it revealed that she was suffering from Rapunzel's Syndrome.

Dr Venkatesh M Annigeri, a consultant pediatric surgeon, noticed a complete blockage in the girl’s small intestine during the examination.

The extremely rare condition is named after the fairy tale princess, Rapunzel, who had very long tresses. This condition is usually found in young girls who have a habit of eating or ingesting hair.

“With ultrasound in the abdomen and Contrast-Enhanced Computerised Tomography [CECT], the child was diagnosed with a rare clinical condition, primary small bowel trichobezoar, which was causing acute intestinal obstruction,” said Dr Annigeri.

Trichobezoar refers to a mass of hair accumulated within the gastrointestinal tract.

Doctors then conducted surgery on Diya and retrieved a ball of hair measuring 20cm long and 4cm thick from her small intestine on October 18.

Trichobezoar is associated with a psychiatric disorder that affects young girls. Sufferers tend to pull their hair and eat it. The consumed hair does not get digested.

The hair had accumulated in Diya's gastric tract, explained Dr Annegiri.

The girl's father, Rajesh A.M said that they were shocked after finding out about their daughter's condition. “Diya used to pick up stuff from the floor, sometimes from under the bed or tables and eat it,” he recalled, adding that they were lucky to have her condition was caught at an early age.

“It could have caused more problems after a few years,” said Rajesh.

Doctors advise parents to keep a strict vigil on children with such habits and consult a medical expert if children complain of such disorders.

Rajesh said that his daughter is doing fine after being discharged from the hospital on October 24.

“Doctors have prescribed a strict diet and Diya should not consume junk food,” said Rajesh.