Full Breakdown
Teen’s Rare Hairball Surgery Highlights Hidden Risks of Trichophagia
9/6/2026, 7:56:43 PM
Core Event
A 16-year-old girl was taken to an emergency department after a day of persistent vomiting. A computed tomography (CT) scan revealed a large trichobezoar—a hairball lodged in her stomach and extending into the duodenum—that was obstructing her gastrointestinal (GI) tract. Because endoscopic removal was not possible, surgeons performed an operation to extract the mass.
Clinical Details
The case was documented in the *Journal of Medical Case Reports* (Despart et al., 2026). The patient reported that she had begun pulling and swallowing her hair about two years earlier, typically removing only three hairs at a time on a weekly basis. She denied recent stressors, trauma, abuse, or any psychiatric diagnosis, and she showed no visible hair loss. Apart from the hair-eating behavior, she experienced migraine-associated cyclic vomiting that had led to homeschooling. Post-surgery, she was prescribed sertraline—a medication used for anxiety, depression, and obsessive-compulsive disorder (OCD)—and was referred for cognitive-behavioral therapy before discharge.
Background & Context
Trichotillomania is a compulsive hair-pulling disorder often used for self-soothing. When combined with trichophagia (hair-eating), it can produce a trichobezoar, a mass of indigestible keratin that accumulates in the GI tract. In extreme cases, the condition is termed “Rapunzel syndrome,” referring to hairballs that extend beyond the stomach into the intestines. Although trichobezoars are rare, they can become life-threatening if they cause obstruction.
Implications for Diagnosis
The authors of the case report emphasize that clinicians should consider trichobezoar in adolescent females presenting with nausea, vomiting, or abdominal pain, even when there is no obvious hair loss or diagnosed psychiatric disorder. They note that social stigma surrounding trichotillomania and trichophagia often leads patients to conceal these behaviors, making early detection challenging.
Awareness and Follow-Up
By publishing this case, the medical team aims to raise awareness of Rapunzel syndrome’s potential to develop silently. The recommendation is for healthcare providers to maintain a high index of suspicion for trichobezoars in relevant clinical presentations and to address underlying compulsive behaviors through appropriate psychiatric referral and medication.
