An unanticipated difficult airway in Lesch-Nyhan syndrome

• Main Authors: Rashmi Salhotra, Chhavi Sharma, Asha Tyagi, Surendra Kumar, A K Sethi, Shuchi Bhatt
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2012-01-01
• Series: Journal of Anaesthesiology Clinical Pharmacology
• Subjects: Difficult airway; Lesch-Nyhan syndrome; tracheal diverticulum
• Online Access: http://www.joacp.org/article.asp?issn=0970-9185;year=2012;volume=28;issue=2;spage=239;epage=241;aulast=Salhotra

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.