Rapunzel syndrome: 1-kg hair mass removed from nine-year-old’s stomach and small intestine in Keralam
A rare and complex surgery at a private hospital in Thiruvananthapuram, Keralam, removed a 1-kg mass of hair from the stomach and small intestine of a nine-year-old girl diagnosed with Rapunzel syndrome, hospital authorities said on Saturday.
The procedure was performed at NIMS Medicity in nearby Neyyattinkara after the child was admitted with persistent abdominal pain and recurrent vomiting. According to a statement from the hospital, imaging and diagnostic tests revealed a severe intestinal obstruction caused by a large hairball, medically known as a trichobezoar, that had extended from the stomach into the small intestine.
How the case unfolded
Hospital officials said the child’s symptoms prompted an ultrasound and CT scans, which indicated significant intestinal blockage. A subsequent endoscopy confirmed the presence of an extensive hair mass occupying the stomach and reaching into the small intestine, consistent with Rapunzel syndrome.
The entire hairball was removed during a complex surgical procedure led by Dr. Biju I. G. Nair, senior consultant in the Department of Paediatric Surgery at NIMS Medicity. Following the operation, the girl made a satisfactory recovery, resumed normal eating, and was discharged, the hospital said.
Understanding Rapunzel syndrome
Rapunzel syndrome is an extremely rare condition in which a trichobezoar originating in the stomach extends into the small intestine. It is most commonly reported in adolescent girls, according to medical literature. Hospital authorities noted that fewer than 100 cases have been documented worldwide.
Explaining the condition, Dr. Nair said a trichobezoar forms when a person repeatedly pulls out and swallows hair. Because hair is indigestible, it can accumulate over time in the stomach, compacting into a hard mass that may eventually cause intestinal obstruction.
Successful outcome and significance
In this case, the timely diagnosis through imaging and endoscopy allowed surgeons to comprehensively remove the obstruction. The hospital reported that the child’s postoperative course was uneventful and that she was able to return to a normal diet before discharge.
The case underscores both the rarity of Rapunzel syndrome and the potential severity of complications arising from trichobezoars, which can progress to life-threatening intestinal obstruction if not identified and treated.
