Awake Fibreoptic Intubation in a Patient with Oral Submucous Fibrosis with a Full Stomach Posted for Emergency Laparotomy: A Case Report

Oral Submucous Fibrosis (OSMF) with temporomandibular joint ankylosis presents significant challenges to airway management due to restricted mouth opening and fibrosis involving the oropharyngeal tissues. The situation becomes more critical in emergency surgeries with a full stomach, where the risk of aspiration further complicates airway planning. This was a case of a 56-year-old female with known OSMF and restricted mouth opening posted for emergency laparotomy due to a faecal fistula formation at the laparoscopic cholecystectomy port site. Given the anticipated difficult airway and full-stomach status, Awake Fibreoptic Intubation (AFOI) was planned and successfully executed. Awake fibreoptic intubation remains the gold standard in managing anticipated difficult airways, especially when complicated by additional risks like upper airway tumours or infections, cervical spine instability, congenital facial abnormalities, previous difficult intubation, and emergency conditions involving a full stomach where aspiration risk is high. This case reinforced its value in ensuring patient safety in emergency surgical scenarios.