Clitoral hair tourniquet in a 5-year-old: A case report and review of the literature.

INTRODUCTION

Hair-thread tourniquet syndrome (HTTS) is an uncommon yet potentially serious condition where strands of hair or thread constrict an appendage, leading to pain, swelling, and possible ischemia. Although more commonly observed in digits, it can occasionally affect external genitalia, particularly in the pediatric population, where involvement of structures such as the clitoris or labia is especially rare.

CASE PRESENTATION: We present a rare case of hair-thread tourniquet syndrome involving the clitoris in a 5-year-old girl. The condition was effectively managed by meticulous removal of the encircling hair, without the need for surgical intervention. Following the procedure, the clitoral anatomy and function returned to normal, with no signs of ischemia or tissue compromise. The patient had an uneventful postoperative course and was discharged on the same day.

RESULTS

HTTS is a rare condition where a strand of hair constricts an appendage, leading to pain, edema, and potential tissue damage, most commonly in fingers, toes, and the genital region. It is typically accidental, with factors like autism and poor hygiene being possible contributors. Early diagnosis and rapid removal of the constricting hair are critical to prevent complications such as necrosis or amputation. Healthcare providers should consider HTTS in infants with unexplained irritability and educate parents on monitoring for signs of strangulation.

CONCLUSION

Clinicians should remain vigilant for hair-thread tourniquet syndrome when evaluating unexplained swelling of appendages in pediatric patients. Prompt recognition and timely intervention are critical to avoid serious complications, including ischemia, necrosis, permanent tissue damage, or even amputation.