title: Emergent Airway Management of an Uncooperative Child with a Large Retropharyngeal and Posterior Mediastinal Abscess.
abstract: Retropharyngeal abscesses are deep neck space infections that can lead to life-threatening airway emergencies and other catastrophic complications. Retropharyngeal abscesses demand prompt diagnosis and early establishment of a definitive airway when there is airway compromise. This can be difficult in an uncooperative patient. We present the case of a 12-year-old girl with mediastinitis and tracheal compression and anterior displacement from a large retropharyngeal and posterior mediastinal abscess secondary to traumatic esophageal perforation, who received successful awake nasal fiberoptic intubation. Anesthesiologists must be prepared for airway emergencies in uncooperative patients, especially children, but there is controversy concerning the use of sedation.
authors.affiliation: From the *Department of Anesthesiology and Perioperative Medicine, Rutgers New Jersey Medical School, Newark, New Jersey; †New Jersey Medical School, Newark, New Jersey; ‡Division of Pediatric Surgery, Hackensack University Medical Center, Hackensack, New Jersey; and §Division of Pediatric Anesthesiology, Hackensack University Medical Center, Hackensack, New Jersey.
authors.forename: Jack
authors.initials: J
authors.lastname: Diep
authors.forename: David
authors.initials: D
authors.lastname: Kam
authors.forename: Keith A
authors.initials: KA
authors.lastname: Kuenzler
authors.forename: Jill F
authors.initials: JF
authors.lastname: Arthur
mesh_terms: D058109:Airway Management / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D007440:Intubation / Q000379:methods; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000601:surgery; D009666:Nose; D010349:Patient Compliance; D017703:Retropharyngeal Abscess / Q000175:diagnosis* / Q000601:surgery