Journal of Anaesthesiology Clinical Pharmacology (Jan 2012)

An unanticipated difficult airway in Lesch-Nyhan syndrome

  • Rashmi Salhotra,
  • Chhavi Sharma,
  • Asha Tyagi,
  • Surendra Kumar,
  • A K Sethi,
  • Shuchi Bhatt

DOI
https://doi.org/10.4103/0970-9185.94909
Journal volume & issue
Vol. 28, no. 2
pp. 239 – 241

Abstract

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An 11-year-old boy with Lesch-Nyhan syndrome presented to the emergency for fixation of a fractured femur. During induction of general anesthesia, unexpected difficult intubation was encountered with a 6.5-mm ID endotracheal tube and successively smaller tubes, also failing to pass 1 cm beyond the vocal cords. Intubation was finally achieved with a 4.5-mm ID tube. The surgery was completed uneventfully. A tracheal diverticulum was found in the computerized tomography (CT) scan performed postoperatively to account for this unexpected difficult intubation. This case highlights the anesthetic concerns in Lesch-Nyhan syndrome and also reports the rare occurrence of a tracheal diverticulum associated with it.

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