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 (also known as Karen Shannon), who worked as a supervisor at Debenham’s, did not proceed with the 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 experienced a dramatic loss of weight. She presented at the Mater Hospital on February 13, 2015, complaining of abdominal pain. She was described as thin, malnourished and disorientated and had lost between three and four stone (20kg-25kg) over a two-month period, the court heard.
Ms Carroll was admitted to the Mater Private Hospital on that date suffering from dehydration. Tests showed a hairball extending from her stomach into the second section of her intestine with a diameter ranging 6.2cm to 10cm. The first section alone, the duodenum, measures between 25cm and 38cm.
The woman was treated with nutritional supplements and the painkiller Tramadol from the time of admission. On the morning of February 17, she complained of hiccups and nausea, with abdominal pain and tenderness. She later collapsed on the ward. Emergency surgery was performed to remove the hairball 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 19. The cause of death was septic shock due to bronchial pneumonia, due to gastric obstruction secondary to the 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 planned surgery to remove the hairball in 2009 was postponed for six weeks initially as Ms Carroll was taking an oral contraceptive. She did not return to hospital to proceed with surgery, the court heard.
Coroner Dr Myra Cullinane returned a narrative verdict setting out the “complex” circumstances of the case and extended her sympathies to the family.