Sagaya Fernando Mumbai: 6 November 22 A team of doctors at Apollo Multispecialty hospital in Triuchirappalli, Tamil Nadu, India, saved the life of a 33-years-old man whose neck was pierced through by a feet long iron rod. Karthikeyan, a resident of Ariyamangalam in the city, was watering the concrete slabs on the first floor of his under-construction house when he accidentally slipped and fell 15 to 20 feet down, on October 15. As he fell, a 5 feet long iron rod with serrated edges pierced through his neck and came out from the back. “Within fifteen minutes of the mishap, his relatives rushed him to our hospital which is in close vicinity,” informed Apollo Multispecialty Hospital, Triuchirappalli, Consultant General, Laparoscopic and Bariatric Surgeon Dr Mohamed Mansoor, who led the operating team. “On evaluation in emergency, it was seen that he had a 5 feet long iron rod penetrating into the anterior aspect of neck and exiting the posterior aspect of neck.
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Sagaya Fernando
Mumbai: 18 September 2018
In a very rare medical case, doctors in India removed a lump of hairball weighing 1 kg and about a meter long from the stomach of a 6 year-old-girl who was suffering from trichophagia along with wheat allergy.
The girl from Dad village on the outskirts of Ludhiana city in Punjab, India, was diagnosed with wheat allergy in April this year.
“Her parents brought her to me in the last week of August with severe abdominal pain and a lump in the stomach. They also informed that she has been eating her hair, which in medical terms is called trichophagia,” informed Dr Daljit Singh of Anmol Hospital, Ludhiana, who conducted the surgery.
He further added, “She was very underweight and weak for her age. Though she was 6 years old, she weighed only 14 kilograms.”
“We got an ultrasound test done which showed some mass in her stomach. Because of her history of eating hair and the presence of a large mass, we conducted an endoscopy which confirmed it as a case of trichobezoar – the presence of hair mass in the stomach. As the mass was too big and not possible to have it removed laparoscopically or endoscopically we had to go for open surgery which was done on September 4,” said Dr Singh.
“The large lump of hair had completely taken the shape of her stomach. When I started removing it, I noticed that it was extending all the way into the patient’s small intestine. The length of the tail of this hairball mass was around one meter,” said he.
This unusual form of bezoar extending from the stomach to the small intestine or beyond is described as Rapunzel syndrome. The name ‘Rapunzel’ syndrome comes from the Grimm Brothers’ fairy tale of a 12-year-old princess who was shut into a tower with neither stairs nor doors by an enchantress who climbed up the tower’s walls with the help of Rapunzel’s long tresses.
“Due to gastric or psychiatric disorder, such patients start eating their own hair and are common mostly to girls. Such patients need counseling so that they don’t start eating hair once again,” said Dr Singh.
“This is a very rare case, and on searching medical journals, I have come across only 40 such cases being reported worldwide so far. Of these, the youngest child was 5-years-old from the United States, and from India, I could not find such a small child having been treated for Rapunzel’s syndrome. When we correlated it with wheat allergy we could find only 4 cases reported in the medical literature,” informed Dr Singh.
She was discharged on September 10, and is doing fine now, said he.
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