Pédiatrie clinique : libre accès
Libre accès

Abstrait

19-Month-Old Male Presenting with Near Strangulation by Human Hair

Aanchal Sharma and Dana Kaplan

Hair tourniquet syndrome is a well-documented phenomenon in which hair can become tightly wrapped around an appendage resulting in ischemic injury and necrosis. When a hair tourniquet involves the neck as the appendage, fatality can result due to asphyxia, specifically strangulation. We present a case of accidental strangulation via hair tourniquet in a toddler who was found co-sleeping with his sister.

A nineteen-month-old male was brought into the emergency department via ambulance after an episode of apnea and cyanosis. On the night of admission, his parents awoke after they heard the patients sister screaming. The parents ran into the bedroom, where the patient and his five-year-old sister were co-sleeping, to find the patient cyanotic with loss of consciousness. EMS was called and patient regained consciousness without intervention by EMS. Vital signs were stable upon presentation to the ED. On physical examination, a linear circumferential mark on the patient’s neck was noted as well as scattered petechiae on his cheeks. X-ray of his neck revealed hypopharyngeal dilatation. Liver enzymes were normal. Skeletal survey and Doppler studies of neck vasculature were normal. Child protective services and law enforcement were notified. Upon investigation, the sister’s hair was confirmed to be at the level of the sacrum, with pieces of hair missing, which were found near the bed where the patient and his sister were sleeping. The case was deemed an accident and the patient was discharged home to his family.

Given the rare presentation in this case, it is essential to consider child abuse as a differential and involve law enforcement agents and/or child protective services to confirm scene investigation is consistent with the history provided to the medical team. In addition, consultation by the child abuse pediatrician was initiated and a skeletal survey was performed, which was negative for additional injury.