Went to the hospital with stomach pain, 2 kilos of hair removed from her stomach!

A female patient who had repeatedly visited other health centers with complaints of persistent abdominal pain and nausea in Osmaniye, and whose symptoms continued, later applied to a private healthcare facility.

The patient, who was examined here by Internal Medicine Specialist Dr. Turgay Güler, was found to have a foreign object in her stomach as a result of the tests performed. The patient, who was decided to be taken into surgery, underwent a surgical procedure performed by General Surgery Specialist Assistant Professor Dr. Seçkin Akküçük.

During the surgery, a total of 2 kilograms of hair mass was removed from the 40-year-old female patient, including 2 pieces measuring 12-13 centimeters from her stomach and 3 pieces measuring 10 centimeters in length from her small intestine. It was reported that the patient's health condition is good following the surgery and that she will be discharged in the coming days.

Stating that he performed the surgery for a rare case, Assistant Professor Dr. Seçkin Akküçük said, "Our patient is a 40-year-old woman who had previously applied to other centers with complaints of frequent vomiting for about a month to a month and a half. Afterwards, she applied to our hospital's internal medicine clinic. Due to the deterioration of her general condition—because she had been vomiting for a long time, the body was naturally unable to receive sufficient food, minerals, and vitamins, or was losing what it did receive—a general deterioration occurred. We admitted our patient with this general deterioration and began her examinations with our internal medicine specialist, Mr. Turgay Güler.

During this time, in the examinations that we were also involved in, we determined that there were large hairballs, which we call trichobezoars, consisting of undigested food, hairballs, or certain medications, that were causing a blockage in her stomach and small intestine, filling almost the entire stomach. We waited a little longer for our patient's general condition to recover with the necessary support and treatment, and after her general condition became suitable for surgery, we performed our operation yesterday. We removed 2 bezoars of approximately 12-13 centimeters from her stomach and 2 bezoars of approximately 10-11 centimeters that were completely blocking her small intestine. Currently, our patient's general condition is quite good, and the vomiting has naturally ceased. We are now in the recovery phase. We hope to discharge our patient in a healthy state within a few days," he said.

Stating that they diagnosed the patient with the rare Rapunzel syndrome, Assistant Professor Dr. Seçkin Akküçük continued his words as follows;

"Bezoars are very rare; they are not seen very often. Some undigested vegetable food residues can accumulate in the stomach; we call this a phytobezoar. There may be hair-eating habits; due to some psychological disorders, we call it a trichobezoar. It is even referred to in the literature as Rapunzel syndrome. Rapunzel has a special fairy tale; it is a story of a princess who tries to escape by letting her hair grow from a tower, and the name Rapunzel syndrome was inspired by this. It is mostly seen in the stomach, and rarely in the small intestine.

One of the features that made this patient interesting was that she had separate, isolated bezoars in both the stomach and the small intestine. Sometimes, and much more rarely, they can form after medications given do not dissolve, and they can even be related to the inability to digest milk in newborns or children in the infancy stage, but we see those very, very rarely. The most common one we see is the phytobezoar, followed by the trichobezoar, which arises from the habit of hair-eating; our patient also had a trichobezoar.

We hope that she will receive the necessary support to overcome that habit from now on. Bezoars are mostly noticed late because they do not show clinical symptoms until they reach a certain size. If the patient's relatives had not suspected anything due to this habit and had not gone to a physician, they would have reached the point of advanced blockages, as in this patient.

Sometimes they can lead to bleeding; our patient did not have bleeding, but her stomach was inflamed to the point of being close to bleeding. Unfortunately, treatment with medication is not really possible. While the phytobezoars we mentioned—vegetable residues—or lactobezoars seen in children might be attempted to be dissolved with dissolving enzymes or acidic foods and drinks, surgery is required most of the time. There is no place for medication treatment for trichobezoars anyway. Therefore, surgery is necessary, and we successfully performed our operation."