Hairball of 10cm diameter a factor in death of woman (24)

A 24-year-old woman died of complications arising from a hairball that extended more than 25cm from her stomach into her intestines, an inquest has heard.

Surgery was recommended for Karen Carroll from Portland Square, North Circular Road, Dublin 1 in 2009 but this did not happen and she died five years later.

The hairball, known medically as trichobezoar, is associated with a rare condition called Rapunzel Syndrome which results from the ingestion of hair.

The young woman, who worked as a supervisor at Debenham’s, did not proceed with the planned surgery to remove the large mass of hair from her intestines but continued to live a full life over the next five years, Dublin Coroner’s Court heard.

Towards the end of 2014 she became unwell and had dramatic weight loss. She went to the Mater Hospital on February 13th 2015 with abdominal pain. She was described as thin, malnourished and disorientated and had lost between three and four stone in two months, the court heard.

Ms Carroll was admitted to the Mater Private Hospital on that date suffering from dehydration. Tests showed a large hairball extending from her stomach into the second section of her intestine with a diameter ranging between 6.2 and 10cm. The first section alone, the duodenum, measures between 25cm and 38cm.

Septic shock

The young woman was treated with nutritional supplements and the painkiller Tramadol from the time of admission. On the morning of February 17th, she complained of hiccups and nausea, with abdominal pain and tenderness. She collapsed on the ward later that day. Emergency surgery was performed to remove the hairball from her stomach and doctors found the mass of hair had fractured and moved further into the small bowel. Ms Carroll remained in a critical condition following surgery and died on February 19th.

The cause of death was septic shock due to bronchial pneumonia, due to gastric obstruction secondary to trichobezoar.

Pathologist Dr Niall Mulligan said the woman developed pneumonia two to three days before she died. The hairball was affecting her ability to breathe as it was pushing against her diaphragm on the left side, the court heard.

Consultant in emergency medicine at the Mater Private Hospital Dr Gerard O’Connor said this was only the second case of trichobezoar he had experienced in his career. The court heard that planned surgery to remove the hairball in 2009 was postponed for six weeks initially. She did not return to hospital to proceed with surgery.

Coroner Dr Myra Cullinane returned a narrative verdict setting out the "complex" circumstances of the case and extended her sympathies to the family.