title: Dangerous blind tracheal intubation attempt due to fiberscope non-availability in a pediatric patient with retropharyngeal abscess caused by a large fish bone.
abstract: In China, foods containing bones are sometimes fed to young infants. Occasionally, this practice results in bone aspiration and retropharyngeal abscess, a potentially life-threatening infection in the deep space of the neck that can compromise the airway. The main concern in managing patients with retropharyngeal abscess is airway management. In China, not all hospitals and operating rooms are equipped with fiberscopes, particularly pediatric-size fiberscopes. Emergency airway management can be dangerous when a fiberscope is unavailable. We present the case of a 21-month-old baby girl with a retropharyngeal abscess secondary to fish bone ingestion. During an attempted blind tracheal intubation due to fiberscope non-availability, the abscess ruptured, and the pus released from it obstructed the airway. The patient was successfully treated despite the inadequate resources and dangerous complication. We recommend a detailed preoperative airway assessment and preparation for fiberscopic tracheal intubation in such patients to prevent this dangerous complication.
authors.affiliation: Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou, P. R. China.
authors.forename: Bi-Lian
authors.initials: BL
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou, P. R. China.
authors.forename: Ying-Yi
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Department of Nutrition, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou, P. R. China.
authors.forename: Yan-Fang
authors.initials: YF
authors.lastname: Jiang
authors.affiliation: Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou, P. R. China.
authors.forename: Wen-Xing
authors.initials: WX
authors.lastname: Liu
authors.affiliation: Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou, P. R. China.
authors.forename: Xiao-Hua
authors.initials: XH
authors.lastname: Kuang
authors.affiliation: Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangzhou, P. R. China.
authors.forename: Jin
authors.initials: J
authors.lastname: Ni
keywords: Fish bone; retropharyngeal abscess; tracheal intubation