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Journal of Case Reports
Anaesthetic Management of Unexpected Subglottic Stenosis in a Neonate with Tracheoesophageal Fistula
Raksha Kundal, Avnish  Bharadwaj, Neelam  Dogra, Priyanka Jain, Samridhi Nanda,
Vijay Kumar Kundal1
From the Department of Anaesthesia and Department of Paediatric Surgery1, S.M.S. Medical College & associated SPMCHI, Jaipur-302004, India.
Corresponding Author:
Dr. Vijay Kumar Kundal
Email: vijayraksha@yahoo.com
Received: 21 MAY 2013 Accepted: 3-JUNE-2013 Published Online: 10-JUL-2013
DOI: http://dx.doi.org/10.17659/01.2013.0051
Abstract
Esophageal Atresia (EA) with Tracheoesophageal fistula (TEF) can be complicated by aspiration, respiratory distress and other congenital anomalies. We present a case of 1 day old neonate posted for Tracheoesophageal fistula repair who was found to have subglottic stenosis after induction of anaesthesia. A Cormac –Lehane grade 1 direct laryngoscopic view was obtained following induction of anaesthesia, however it was not possible to intubate the patient with  even smallest size 2.0 mm endotracheal tube. Ventilation with size 1 Laryngeal mask airway was adequate. Failed intubation with smallest size endotracheal tube led us to suspect subglottic stenosis. In view of necessity of endotracheal intubation in EA with TEF surgery, this case highlights the importance of management of unexpected subglottic stenosis in neonate in an emergency setting.
Keywords : Esophageal Atresia, Tracheoesophageal Fistula, Intubation, Laryngoscopy, Pathologic Constriction.
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