Failed intubation secondary to complete tracheal rings: a case report and literature review

Area of Science:

• Pediatric Anesthesiology
• Neonatal Surgery
• Medical Case Reports

Background:

• Congenital tracheal anomalies typically present with noticeable airway issues in infants.
• Difficult intubation in asymptomatic neonates is uncommon.
• Complete tracheal rings are a rare congenital anomaly affecting airway patency.

Observation:

• An 8-day-old asymptomatic infant experienced an unanticipated difficult intubation.
• The infant was found to have complete tracheal rings.
• Ventilation was successfully achieved using a laryngeal mask airway (LMA).

Findings:

• Complete tracheal rings can lead to unexpected airway obstruction and failed intubation in asymptomatic infants.
• The use of an LMA provided a viable alternative for ventilation in this challenging case.
• Surgical intervention (ventricular-peritoneum shunt placement) was successfully completed post-stabilization.

Implications:

• Highlights the importance of considering rare congenital anomalies in cases of difficult infant intubation, even without prior symptoms.
• Demonstrates the utility of LMAs as a rescue device in neonatal airway emergencies.
• Underscores the need for prompt diagnosis and management of congenital tracheal anomalies to ensure patient safety during procedures.