Case Report

Successful Anaesthetic Management Of Meckel-Gruber Syndrome: A Case Report

Abstract

Meckel Gruber syndrome (MGS) is one of the rare autosomal recessive inherited disorder affecting several organ systems of the body. It is specifically characterised by occipital encephalocele, bilateral polycystic kidney, post axial polydactyly making the airway management difficult.
We would like to share successful management of a case of Meckel Gruber syndrome with giant occipital-cervical encephalocele posted for excision. Difficult airway cart was kept ready prior to intubation. This includes laryngeal mask airway of appropriate size, high frequency jet ventilation, fibre-optic bronchoscope, a cricothyroid cannula and preparations for tracheostomy.
Anaesthesia to paediatric age group poses many challenges to anaesthesiologist and that for congenital anomalies add to it. Working knowledge of these kind of syndromes and specific considerations for the same should be kept in mind when assessing a case of occipital encephalocele leading to more effective and appropriate management of cases.

[1] Parelkar SV, Kapadins PS, Sanghvi BV, Joshi DM, Mundada D, Oak SN. Meckel-Gruber syndrome: A rare and lethal anomaly with review of literature. J Pediatr Neurosci. 2013;8(2):154-7.
[2] Motoyama E, Davis P (1990) Clinical management of special surgical problems; anesthesia for general, urologic, and plastic surgery. In: Smith’s anesthesia for infants and children. 5th edn. Mosby, St. Louis, p607.
[3] Meckel JR. Beschreibung zweier durch sehr alnliche Bildungsaweichung entseller Geschwister. Dtsch Arch Phiol. 1898; 7:99.
[4] Paavola P, Salonen R, Weissenbach J, Peltonen L. The locus for Meckel syndrome with multiple congenital anomalies maps to chromosome 17q21–q24. Nat Genet. 1995; 11(2):213.
[5] de Silva MV, Senanayaka H, Siriwardana KD. Meckel Gruber syndrome: occurrence in non-consanguineous marriages. Ceylon Med J. 2004; 49(1):30-1.
[6] Creighton RE, Relton JES, Meridy HW. Anaesthesia for occipital encephalocele. Can Anaesth Soc J. 1974; 21(4): 403-6.
[7] Newfield P, Hamid RKA. Anaesthesia for paediatric neurosurgery. In: Cottrell JE, Smith DS (editors): Anaesthesia and Neurosurgery. 4th ed., Mosby, 2001: 519-20.
[8] American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013; 98(5):1269-77.
[9] Mahajan C, Rath GP, Bithal PK, Mahapatra AK. Perioperative management of children with giant encephalocele: a clinical report of 29 cases. J Neurosurg Anesthesiol. 2017; 29 (3):322-9.
Files
IssueVol 6 No 3 (2020): Summer QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/aacc.v6i3.3999
Keywords
Meckel Gruber syndrome Encephalocele Airway

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Krishna V, Govil N, Adabala V, Chaturvedi J. Successful Anaesthetic Management Of Meckel-Gruber Syndrome: A Case Report. Arch Anesth & Crit Care. 2020;6(3):142-144.