Clitoral Hair Tourniquet: A Case Report and Review of the Literature

The document from 2015 is a case report and review of the literature on hair tourniquets, specifically involving the clitoris of a child. Hair tourniquets are uncommon occurrences in children that can have devastating consequences. They are typically found on fingers and toes, but can also involve the genitalia. The case involved a five-year-old girl who presented with swelling over her clitoris due to a hair tourniquet. The hair was removed in the operating room under anesthesia. Hair tourniquets tend to occur in young children, but can also occur in older patients. The median age of hair tourniquet of the clitoris is eight years. The hair or thread causing the tourniquet needs to be removed as soon as possible to prevent serious complications, including necrosis or autoamputation. The mechanism of injury begins with lymphatic occlusion, which causes impaired venous drainage; the subsequent edema then leads to obstruction of arterial flow and necrosis. The etiology of the hair must be carefully considered as intentional application for cultural beliefs or child abuse has been associated in addition to inadvertent or accidental hair tourniquets. Hair tourniquets have also been suggested to be associated with telogen effluvium, when mothers have increased hair shedding for 2-6 months postpartum.