Case Report: Anesthesia for emergent gastroscopy in a pediatric patient with Bartter's syndrome

Bartter's syndrome (BS) is a rare inherited disorder characterized by salt-wasting alkalosis and hypokalemia. Perioperative management of BS patients remains limited, with most of them undergoing elective surgery. We presented a case report about a 12-year-old BS child who underwent an emergent gastroscopy due to acute gastrointestinal bleeding. The patient was presented to the operation room with hypokalemia, hyponatremia, severe anaemia, and hemorrhagic shock. The gastroscopy was performed under general anesthesia, and the patient was hemodynamically stable throughout the whole process. Finally, the patient was discharged with no complications. The perioperative challenges of BS patients mainly come from the dramatic metabolic disturbances. The perception of the pathophysiology of BS and the patient-based status may help to recognize risks and thus minimize the morbidity and improve outcome, even in an emergent situation.