Post-operative airway obstruction in Noonan syndrome: An unusual presentation

Noonan syndrome (NS) is an autosomal dominant disorder with craniofacial, cardiac, skeletal abnormalities, haemorrhagic diathesis, with reported incidence of 1 in 1000 to 1 in 2500 live births.[1] Various lymphatic abnormalities have been observed in these patients including pulmonary and intestinal lymphangiectasia and lymphoedema.[2] Craniofacial dysmorphism webbed neck and atlantoaxial instability can complicate airway management.[3] The anaesthetic considerations include difficult airway, impaired cardio-pulmonary function, mental retardation, and short stature. We report an unusual presentation of airway obstruction due to bronchial cast on 5th post-operative day in a case of NS, who underwent laparoscopic orchidopexy.