New Delhi: A 20-year-old MBBS student who had been eating strands of her own hair for nearly 11 years underwent a surgery at Manipal Hospital Dwarka after doctors found a massive 1.16 kg hairball filling her stomach and extending towards the small intestine.The patient, who had been consuming her hair since childhood, came to the hospital after three days of severe abdominal pain, nausea and repeated vomiting. She also had a longer history of poor appetite, weight loss and fatigue.Doctors found a hard lump in her upper abdomen. An upper gastrointestinal endoscopy subsequently revealed a large trichobezoar — a compact mass of swallowed hair that had accumulated in the stomach over several years. As hair cannot be digested, it can gradually collect along with food and form a dense mass.In this case, the mass was described as J-shaped, extending from the junction of the food pipe and stomach to the opening leading into the small intestine. It had occupied much of the stomach and caused severe gastric distension.Dr (Prof.) Sandeep Aggarwal, chairman, Manipal Institute of Minimal Access, Bariatric, GI & Robotic Surgery, said doctors initially attempted to break up the mass endoscopically, but its size and density made complete removal through the endoscope impossible.“The stomach was completely packed with this huge trichobezoar, and there was hardly any space for manipulation of the mass,” Aggarwal said. There was also a risk of injuring the stomach lining, he added.Doctors therefore proceeded with laparoscopic guidance and ultimately made a small abdominal incision to safely release the hairball from the stomach lining and remove it in its entirety.The behaviour of repeatedly swallowing hair is known as trichophagia. People may not always recognise the behaviour as a medical problem or disclose it to doctors, allowing hairballs to build up silently over years.“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,” Aggarwal said.Following the surgery, the patient’s abdominal symptoms improved, and her appetite and ability to tolerate food gradually returned. She has since gained weight and resumed her studies.Doctors said that surgery addresses the physical complication, but recognising trichophagia and providing appropriate psychological support are also important to address the underlying behaviour and reduce the risk of recurrence.
