Difficult Airway Management in a Patient With Upper Airway Obstruction Due to Alkali Ingestion: a Case Report

Background: Ingestion of alkaline substances can cause mucosal damage and upper airway obstruction. This is a serious and potentially fatal complication that occurs within the first few hours after ingestion. There has been no established algorithm for emergent airway management in these situations. We present a case of difficult airway management in a patient with upper airway obstruction caused by alkali ingestion, wherein we opted for intubation with video laryngoscopy and successfully treated the patient. Case presentation: An 80-year-old patient accidentally ingested a small amount of alkaline liquid and presented to our hospital with complaints of burning sensation in the throat. Within two hours of arrival at the hospital, the edema in the epiglottis rapidly worsened, resulting in upper airway obstruction. Assuming that intubation and ventilation would be difficult in this situation, we attempted to intubate the patient using fiberoptic bronchoscopy, but it was difficult. Finally, after two unsuccessful attempts, we successfully intubated the patient using a video laryngoscope. Conclusions: : The patient in our case had acute upper airway obstruction due to alkali ingestion, which caused difficulty in tracheal intubation. Our experience, in this case, would likely help emergency physicians to intubate more safely in patients with emergent upper airway obstruction due to alkali ingestion. For intubation in such situations, it would be a reasonable option to use video laryngoscopy.