Case report

Tracheal agenesis as a rare cause of difficult intubation in a newborn with respiratory distress: a case report

Raja Ahmad¹ , Kahairi Abdullah¹ , Lukman Mokhtar² and Ahmad Fadzil³

¹  Department of Otolaryngology - Head & Neck Surgery, Faculty of Medicine, International Islamic University Malaysia, Kuantan 25200, Malaysia

²  Department of Anaesthesiology and Intensive Care, Faculty of Medicine, International Islamic University Malaysia, Kuantan 25200, Malaysia

³  Department of Pediatric, Tengku Ampuan Afzan Hospital, Kuantan 25710, Malaysia

author email corresponding author email

Journal of Medical Case Reports 2009, 3:105doi:10.1186/1752-1947-3-105

Published:	4 November 2009

Abstract

Introduction

Tracheal agenesis is a very rare congenital airway anomaly. It may pose a great challenge to the first attending physician both in diagnosis and in establishing the airway during the first day of life.

Case presentation

We report a newborn Malay baby boy with trachea agenesis (type III by Floyd's classification) who presented with severe respiratory distress immediately after birth. Clinical diagnosis in this case was not straightforward, as it started with difficulty in intubation followed by an unsuccessful emergency tracheostomy in the neonatal intensive care unit. Urgent surgical neck exploration with endoscopic examination in the general operating theatre revealed the final diagnosis. The authors present a short description of the embryopathology and diagnostic criteria of the abnormality.

Conclusion

We hope this case presentation will be valuable in increasing the awareness of physicians about this rare cause of tracheal obstruction or difficult intubation.