Two hairballs removed from women's stomachs in Cape Town consisted entirely of hair extensions.
One of the hairballs was 1.4m long, and the 19-year-old schoolgirl who had it removed told doctors she had been eating her extensions for four years.
She arrived at Groote Schuur Hospital with abdominal pain, and when doctors opened her up they found the hairball extended into the second part of her small intestine.
The two extension hairballs are among only four similar cases reported worldwide. They are reported in the July edition of the South African Medical Journal by surgeon Jeremy Plaskett and colleagues at Groote Schuur.Hairballs that extend into the small intestine are part of Rapunzel syndrome, a "rare and extreme presentation" of an intestinal condition caused by eating hair. It is named after the Brothers Grimm fairy tale.
"Complications include gastric ulceration, perforation with peritonitis, obstructive jaundice, acute pancreatitis and even death," said Plaskett. "Rapunzel syndrome commonly occurs in young females, who usually have an underlying psychiatric disorder."
About one in 10 people with trichotillomania - a compulsive desire to pull out their own hair - also had trichophagia, an obsession with eating hair.
The condition leads to hairballs when strands of hair get trapped in the folds of the stomach lining. Eventually, hairballs become too large to pass beyond the stomach.
Plaskett's hair extension cases, and three involving natural hair, involved "highly functional" women whose symptoms included vomiting and abdominal pain, and a 12-year-old with cerebral palsy and anorexia.BIZARRE REMEDY
Medically, a hairball is known as a trichobezoar. "Bezoar" is believed to be derived from the Arabic for antidote. "In ancient times, bezoars were believed to have medicinal and magical properties and considered as antidotes to a variety of poisons and diseases," said surgeon Jeremy Plaskett...