Difficult intubation in a neonate: a diagnostic dilemma

Area of Science:

• Neonatal Medicine
• Pediatric Surgery
• Pathology

Background:

• Difficult neonatal intubation presents significant challenges, particularly when antenatal information is unavailable.
• Numerous factors contribute to airway obstruction in newborns, necessitating prompt diagnosis.

Observation:

• A late preterm neonate presented with apnea and unmanageable intubation attempts.
• A periglottic mass was suspected as the cause of airway obstruction.

Findings:

• Autopsy revealed an ectopic thymus as the periglottic mass.
• Ectopic thymus can manifest as a previously unrecognized cause of difficult neonatal airway management.

Implications:

• Anticipating ectopic thymus in cases of difficult neonatal intubation is critical.
• Prompt diagnosis and appropriate management strategies for ectopic thymus can prevent severe adverse outcomes, including mortality.