[Anesthetic management of a patient with relapsing polychondritis]

A 71-year-old male patient with relapsing polychondritis was scheduled for elective sigmoidectomy. Relapsing chondritis often causes inflammation of the tracheal cartilages, leading to fragile trachea and bronchus. Preoperative evaluation with 3-dimensional computed tomography showed rightward tracheal shift and nearly 50% narrowing of the right bronchus during expiration phase. His trachea was intubated with fiberoptic-guided intubation under light sedation. General anesthesia was maintained with sevoflurane 2.0% and air 50% in oxygen under mechanical ventilation employing PEEP (5cmH2O). No respiratory complication occurred during general anesthesia. But he suffered pleural effusion and atelectasis on the post-surgical day 2. We should pay attention to 3-dimensional structure of the airway when we perform general anesthesia for a patient with relapsing chondritis.