Placement of a double lumen tube in a patient with difficult intubation due to ankylosing spondylitis--a case report

Abstract

During insertion of the double lumen tube in patients with ankylosing spondylitis, cervical neutral position should be maintained to avoid vertebral and spinal injuries. Although flexible fiberoptic bronchoscopic intubation is the gold standard, available FOB size is not compatible with that of the endobronchial lumen of the double lumen tube. This problem should be solved according to institutional capabilities. In this report we present a case of insertion of double lumen tube in neutral position using flexible fiberoptic bronchoscope and airway exchanger catheter in a thoracotomy patient with extremely limited neck mobility due to ankylosing spondylitis.