Unexpected Difficult Intubation caused by Undiagnosed Laryngeal Tuberculosis in a Patient Requiring Pericardiectomy for Tuberculosis Pericarditis: A Case Report

Abstract

Airway management is a critical aspect of anesthesia, and difficulties in endotracheal intubation can lead to life threatening complications. While an anticipated difficult intubation can be managed with proper preparation and planning, unexpected difficult intubation can be a challenging situation even to skilled anesthesiologists. We experienced unexpected difficult intubation in a 66-year-old male patient with known tuberculosis pericarditis scheduled for elective pericardiectomy surgery. Multiple intubation attempts were made using various techniques, and successful intubation was achieved with a smaller diameter endotracheal tube. Surgery was uneventful and post-operative evaluation of the airway confirmed laryngeal tuberculosis. This case highlights the importance of vigilance in managing unexpected difficult intubation, especially in patients with a history of tuberculosis or immunosuppressive conditions. Prompt recognition of airway stenosis and appropriate interventions are crucial in securing the airway patency to minimize complications in patients with undiagnosed tuberculosis laryngitis.