Keywords
Difficult airway
Fiberoptic bronchoscopy
Awake intubation
Emergency anesthesia
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Abstract
Objective: To report the case of a patient with advanced ankylosing spondylitis (AS) and intestinal obstruction who underwent emergency exploratory laparotomy and whose airway (AW) management was successful. Case details: Ankylosing spondylitis is a chronic inflammatory condition that predominantly affects the spine and can significantly compromise cervical mobility, making airway management a challenge, especially in emergency situations. This report describes the case of an elderly patient with advanced AS who was admitted with intestinal obstruction and required exploratory laparotomy. Given the failure of multiple previous intubation attempts, we opted for an awake bronchoscopy approach, with a safe and satisfactory outcome. Final considerations: The case highlights the importance of individualized strategies and thorough preparation in the management of difficult airways, especially regarding the anticipation of morbid and potentially fatal scenarios. Thus, the central message of this report is that there continues to be an important role for fiberoptic intubation in the management of the airway of patients with ankylosing spondylitis and other diseases that limit cervical spine mobility.
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