Untangling a web: an unusual case of labial necrosis in an adolescent female.
BACKGROUND
Hair tourniquets are commonly described in the pediatric literature. Prompt recognition of a hair tourniquet and treatment with complete removal of the hair by pediatricians, pediatric emergency room physicians, or gynecologists is essential to prevent ischemia and necrosis of affected tissue.


METHODS
Herein we present the case of a 12-year-old female referred to the pediatric surgery clinic for labial pain and swelling. She was found to have a hair tourniquet of the labia minora caused by pubic hair. The patient was taken to the operating room for examination under anesthesia and removal of the hair. Her post-operative course was unremarkable and she was discharged home the following day. On follow-up visit to the clinic her labial edema had completely resolved and she was pain free.


CONCLUSIONS
Unlike previous case reports that describe hair tourniquets as originating from hair on the head, our patient had a hair tourniquet caused by pubic hair. In adolescents where personal hygiene of the perineum is difficult, clinicians need to be aware of the possibility of a hair tourniquet forming from pubic hair.
Division of Pediatric Surgery, Department of Surgery, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA. Electronic address: cas9064@nyp.org.
Cameron
C
Stock
Division of Pediatric Surgery, Department of Surgery, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA.
Lily C
LC
Wang
Division of Pediatric Surgery, Department of Surgery, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA.
Nitsana A
NA
Spigland
D002648:Child; D005260:Female; D006197:Hair; D006801:Humans; D007511:Ischemia / Q000209:etiology; D009336:Necrosis; D014844:Vulva / Q000098:blood supply* / Q000473:pathology*; D014845:Vulvar Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery