Difficult Ventilation due to Upper Airway Bleeding During Dental Surgery in a Homocystinuria Patient – a Case Report

Valsa Abraham, Jithin J* and Himani Garg

Aim and background: Homocystinuria is a rare metabolic disorder with characteristic involvement of connective and vascular tissue associated with increased bleeding risk. This article reports a rare and clinically significant case of difficult ventilation caused by upper airway bleeding in a case of homocystinuria during dental rehabilitation surgery, emphasising the challenges faced in airway management and the tailored anaesthetic care given.

Case report: A 9-year-old female with homocystinuria was taken up for dental rehabilitation surgery. Patient sustained profuse upper airway bleeding after attempted nasal intubation and sudden blockage of both bronchi, which led to difficulty in securing the airway and further ventilation difficulties, which were managed with oral intubation, bronchial suctioning, and tailored care to clear the airways and improve the ventilation. 

Conclusion: In a case of homocystinuria with increased bleeding tendency due to coexisting Aspirin administration, the anesthesiologist should understand the pathogenesis, complications, and tailor the anaesthetic care with minimal airway manipulation and trauma, and manage all difficult ventilation that may arise as a complication of the same.

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Published on: Nov 8, 2025 Pages: 6-8

Full Text PDF Full Text HTML DOI: 10.17352/2455-3476.000060
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