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BMJ Case Reports 2009; doi:10.1136/bcr.07.2008.0595
  • Learning from errors

Congenital laryngomucocoele: a rare cause for CHAOS

  1. Manuel Sousa Cunha1,
  2. Patrícia Janeiro1,
  3. Rosário Fernandes2,
  4. Helena Carreiro1,
  5. Ricardo Laurini3
  1. 1
    Hospital Fernando Fonseca, Pediatrics, IC 19, Amadora, 2720-276, Portugal
  2. 2
    Hospital Fernando Fonseca, Anatomia Patológica, IC 19, Amadora, 2720-276, Portugal
  3. 3
    University Hospital Lund, OB/GYN - Developmental Pathology, University Hospital Lund, Lund, 221 85, Sweden
  1. manuelsousacunha{at}gmail.com
  • Published 27 February 2009

Summary

Congenital high airway obstruction syndrome (CHAOS) is a rare but life-threatening condition that results from the obstruction of the upper airways.

We describe a female newborn, from a Grávida II, Para 0, 36-year-old woman, with a routine ultrasound at 30 weeks’ gestation that showed polyhydramnios. She delivered a live-born female baby at 36 weeks without any dismorphic features but with respiratory distress. Attempts at endotracheal intubation were unsuccessful due to the presence of a mass obstructing the larynx. The reanimation process was stopped after 20 minutes. Post-mortem examination demonstrated the presence of a total occlusion of the larynx by a laryngomucocoele. Laryngocele, a congenital cyst of the larynx, occurs rarely and hardly ever as a cause of CHAOS. What is more, laryngomucocoele has not been previously reported as a cause of CHAOS. These conditions represent a neonatal emergency with reserved prognosis unless diagnosed antenatally allowing for a programmed ex utero intrapartum treatment (EXIT) by performing tracheostomy while maintaining the placental circulation.

Footnotes

  • Competing interests: none.

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