Delayed Diagnosis of Labial Hair Thread Tourniquet Syndrome in a Postmenarchal Adolescent: A Case Report

Abstract

BackgroundHair thread tourniquet syndrome (HTTS) occurs when tissue is strangulated by a hair thread. It most commonly occurs in the digits of infants and young children but can occur in the genitalia. Case ReportA 13-year-old postmenarchal female with several days of severe vulvar pain and swelling presented to the emergency department. Diagnosis was unclear and she was referred to Pediatric and Adolescent Gynecology. Pelvic exam under anesthesia revealed a hair thread tourniquet involving the bilateral labia minora. The hair tourniquet and portions of bilateral labia minora were excised. Why Should an Emergency Physician Be Aware of This?. Genital hair thread tourniquet syndrome is uncommon but must be considered in patients with severe genital pain and swelling. Prompt diagnosis and treatment are important to prevent tissue necrosis and may be facilitated by a pelvic exam with sedation.