P009: DIFFICULT AIRWAY IN A PATIENT WITH SUBGLOTTIC STENOSIS AND A DIAPHRAGMATIC HERNIA
Aisha Khan, BS1; Alan Hsieh, MD2; Karina K Cordeiro, MD2; Diego Lozano2; Frank Vigil Gonzalez, MD2; Richard R McNeer, MD2; 1University of Miami Miller School of Medicine; 2Jackson Memorial Hospital Department of Anesthesiology
We describe the case of a 42-year-old obese male who presented to the emergency department with acute on chronic dyspnea. A decision was made to intubate due to respiratory failure, however intubation was unsuccessful after three attempts by emergency department providers due to difficulty advancing the endotracheal tube passed the clearly visualized vocal cords on video laryngoscope. Anesthesia providers were then unable to advance a bougie despite multiple attempts. Surgeons emergently placed a tracheostomy while ventilation was maintained with laryngeal mask airway. Chest X-ray showed a long segment of subglottic stenosis and a large right diaphragmatic hernia with bowel in the thorax.