Case Report
Volume 4 Issue 1 - 2020
Pitfalls during Anesthetic Management of Dystrophic Epidermolysis Bullosa; A Case Study
Mahamed Salah Eldeen Alkateb*, Walid Hasan Ibrahim Moftah*, Raiya Saif ALBahri and Arpan Kumar Sashankar
Anesthesia and intensive care department, Royal Hospital, Muscat, Oman
*Corresponding Author: Mahamed Salah Eldeen Alkateb and Walid Hasan Ibrahim Moftah, Anesthesia and Intensive Care Department, Royal Hospital, Muscat, Oman.
Received: November 21, 2019; Published: December 05, 2019


Introduction: Epidermolysis bullosa is a group of genetic diseases that leads to a defect in the dermo-epidermal junction. It affects the skin and mucosa leading to blistering and bullae formation on handling. Similar problems can occur in the mouth and pharynx and this can result in poor mouth opening or tracheal stenosis [1].

Case Report: This case study describes the management and anesthetic plan of a dystrophic epidermolysis bullosa (DEB) case who reached the age of 30 years.

This patient presented with dysphagia to solid food and was posted for dilatation of esophageal stricture under General Anesthesia GA. The patient had a history of difficult intubation, Airway assessment revealed Mallampati class 4, missing teeth, and poor oral hygiene with a thyromental distance of less than 3 cm and restricted mouth opening. The procedure was done with awake intubation followed by GA. Gastroenterologist failed to find an esophageal opening after many trials he abandoned the procedure and advised to do Gastrostostomy.

The patient was shifted intubated to ICU. After 72 hours he was sent back to Operating theatre for extubation with backup surgery team for tracheostomy if needed.

Extubation was uneventful, the patient’s family decided to get a second opinion regarding the gastrostomy.

Conclusion: Introducing the best care to DEB patients necessitate Proper planing for each step, and multidisciplinary teamwork, even in simple procedures. Through this study, we will highlight the pitfalls that should be considered in such cases in the future.


Keywords: Dystrophic Epidermolysis Bullosa; Anesthetic Management; Pitfalls


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Citation: Mahamed Salah Eldeen Alkateb, Walid Hasan Ibrahim Moftah., et al. “Pitfalls during Anesthetic Management of Dystrophic Epidermolysis Bullosa; A Case Study”. EC Emergency Medicine and Critical Care 4.1 (2020): 01-07.

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