“Repent, Harlequin!” Said the Bezoar

The things one learns on the internet! Over at the New England Journal of Medicine, the case studies this month include that of a woman found to have a 4.5-kilogram bezoar in her tumtum. Yes, yes, in fact, I did say “kilogram.”
Comic book fans and those who don’t need my candy-apple fairy tale may remember the concept of the bezoar; it appears in an early episode of a certain Beowulf-lover’s The Sandman, wherein a bezoar is needed to cast a spell that’ll imprison the muse Calliope and shake an author loose from his writer’s block — something I am sure a real writer would never do without a really good reason or an approaching deadline on a project for which s/he’s already spent the advance.
What’s a bezoar? Oh, it’s just a “sort of calculus or concretion, a stone found in the intestines of mostly ruminant mammals” — that, or a big chunk of impacted hair in the maw of a human who compulsively munches on his or her delicious tresses. The condition of eating one’s hair is called trichophagia, and can lead to Rapunzel Syndrome, which I recall Mr. Sandman appreciating.
According to NEJM, the young woman in this case had her hairball removed successfully. One year later, we’re told, “She has regained approximately 9 kg of body weight and reports that she has stopped eating her hair.” Which is nice.
While at NEJM I learned about another disease with a fairy-tale name. NEJM tells me: “Harlequin’s Syndrome typically is considered to be an idiopathic, benign condition causing localized failure of the upper thoracic sympathetic chain, with sparing of the first (oculomotor) thoracic segment,” all of which which appears to be a nice way of saying that this female aerobics instructor went to the gym, exercised, and turned all pink on one side. The cause of the condition is a benign tumor that presses on the sympathetic trunk. The tumor was removed; the patient was doing well one year after surgery, though reported to still be exercising.
Bezoar link.
Harlequin’s syndrome link.
Image via the New England Journal of Medicine.

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