A genital hair tourniquet in a 9-year-old girl

The hair tourniquet is a well-described phenomenon. Typically, a hair or filament becomes tightly wrapped around an appendage, thereby causing swelling, pain, and, in extreme cases, necrosis. Affected areas include fingers, toes, and the genitalia. A case of a 9-year-old girl with a clitoral hair tourniquet is described, and a review of the literature of genital tourniquets in females is presented, with a discussion about potential etiology.The hair-thread tourniquet syndrome is a disease in which a hair or filament becomes wrapped around an end-perfusion appendage, thereby limiting adequate venous and lymphatic drainage of that tissue. This results in hyperemia, swelling and pain. If uncorrected, edema and interstitial pressures may increase to prevent adequate vascular supply, and the affected area can progress to necrosis. We are classically taught that this syndrome primarily affects the fingers, toes, and infantile penis and is an important consideration in the differential diagnosis of the colicky infant. The author presents a case of a prepubescent girl with a genital hair tourniquet.