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If you have ever had the pleasure of being around a long-haired cat, you will undoubtedly know what a hairball is, and how disgusting it is when the cat decides to throw it up. The cause of the hairball is the constant licking of the cat’s fur, which collects in the gut and intestine. For a rare number of people, they too develop hairballs, but unlike the cat, it’s not so easy to get them out.
This is a rare syndrome in humans, named after the fairytale by the same name, and is characterized by a psychiatric condition called trichotillomania, where the person pulls out their own hair constantly and repetitively. For some of these people, they also develop trichophagia, where they then eat the hair they have pulled out. As well as patches of baldness, those with this syndrome develop a trichobezoar, which is a hairball that lodges in the stomach.
Symptoms and Complications
There are a large number of symptoms and complications associated with Rapunzel Syndrome, most of which occur in the gastrointestinal system.
Symptoms can include:
- Pain in the abdomen
- Appetite loss
- Nausea and vomiting
- Pale complexion
- Weight loss
- Patchy baldness or hair loss
Complications can include:
- Intestinal and gastric obstruction
- Gastric ulcer
- Intestinal bleeding
- Perforation of the gastrointestinal tract wall
- Destruction of gastrointestinal tract tissue
- Gangrene of the intestine
- Obstructive jaundice
- Acute pancreatitis
Following a physical examination including blood tests, an x-ray is the next diagnostic procedure usually performed. Sometimes, the physician may skip the x-ray and go straight to the CT scanner or MRI machine. The purpose of these radiological tests is to look for gas in the abdomen, which indicates a bowel perforation, and to see if there is a foreign object in the stomach or intestines.
Another procedure used for diagnosis is a fluoroscopy with barium. Barium is swallowed, and then followed using fluoroscopy as it travels through the gastrointestinal system. This barium can stay in the system for quite some time, and further x-rays may be taken later after the barium has exited the body. If there is a hairball, it will have filled with the barium, making it easy to see.