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Updated: May 22, 2026

The Rigid Tube as an Alternative in Controlling the Problematic Airway
Published on: June 6, 2020
An unanticipated difficult airway in Lesch-Nyhan syndrome
Rashmi Salhotra1, Chhavi Sharma, Asha Tyagi
1Department of Anaesthesiology and Critical Care, UCMS and GTBH, Dilshad Garden, Delhi, India.
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.
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