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Floppy epiglottis is rare in the adult population and can rapidly cause airway compromise. This condition is under reported in comparison to laryngomalacia, obstructive sleep apnea and amyopathic lateral sclerosis which also cause complications in airway management. Adult patients with floppy epiglottis can have acute upper airway obstruction in both trauma and non-traumatic conditions. Any intra-oral bleeding and injury can further predispose to complications in airway management.
We reported a case of acute upper airway obstruction in an adult patient with floppy epiglottis. A 53-year-old obese gentleman presented to our Emergency Department with post seizure complicated with continuous intraoral bleeding due to multiple tongue lacerations he sustained. His conditions worsened with inability to speak well, noisy breathing and reduced conscious level.
Definitive airway was performed for impending airway collapse. In this case, the already partially occluded upper airway was aggravated by the presence of floppy and mobile epiglottis detected during intubation process. This warranted the usage of a video laryngoscopy coupled with a bougie to secure his airway.
With the aid of experienced trainers and advanced airway equipment, upper airway obstruction encountered in an adult due to floppy epiglottis can be overcome.
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