title: An unanticipated difficult airway in Lesch-Nyhan syndrome.
abstract: 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.
authors.affiliation: Department of Anaesthesiology and Critical Care, UCMS and GTBH, Dilshad Garden, Delhi, India.
authors.forename: Rashmi
authors.initials: R
authors.lastname: Salhotra
authors.forename: Chhavi
authors.initials: C
authors.lastname: Sharma
authors.forename: Asha
authors.initials: A
authors.lastname: Tyagi
authors.forename: Surendra
authors.initials: S
authors.lastname: Kumar
authors.forename: Ak
authors.initials: A
authors.lastname: Sethi
authors.forename: Shuchi
authors.initials: S
authors.lastname: Bhatt