Dandy Walker Syndrome with Giant Occipital Meningocele- A Paediatric Difficult Airway.

Document Type : Case report

Author

Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI)

Abstract

We present a rare case of Dandy-Walker Syndrome, a congenital brain malformation, accompanied by a giant occipital meningocele. The case highlights the critical role of decision-making during difficult airway management, particularly in pediatric patients. The patient, an 8-month-old female child weighing 5 kg, was brought to our outpatient department with a noticeable giant occipital meningocele. The child was shifted to the operation theatre. Two attempts of direct laryngoscopy failed to visualize even the epiglottis, indicating a challenging airway. To manage the airway, we decided to consider the supraglottic airway as rescue method of ventilation. We used an adult fiberoptic bronchoscope to visualize the glottic opening through the supraglottic airway. Additionally, we inserted a central venous catheter guidewire through the side port of the bronchoscope beyond the vocal cords, which served as a conduit to railroad the endotracheal tube. Overall, the case underscores the importance of quick thinking and appropriate decision-making during challenging airway management, especially in rare and complex cases such as this one.

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