Airway obstruction during general anesthesia is fairly common. Foreign body causing obstruction of the laryngeal mask airway is uncommon but can confuse the anesthesiologist trying to troubleshoot the cause of inability to ventilate. We present a case of complete airway obstruction with a nematode caught in the vertical bars of the laryngeal mask airway after its insertion.

ultrasound was obtained and the diagnosis of pyloric stenosis was made.After a thorough evaluation and discussion with cardiology, cardiovascular surgery, and general surgery a plan was instituted how best to proceed with this procedure from an anesthetic and surgical standpoint. We elected to proceed with an open pyloromyotomy vs the laparoscopic approach secondary to the antecedent risk of abdominal insufflation in an infant with in essence a ductal dependent cyanotic lesion.The patient was taken to the operating room with ASA standard monitors and suctioned awake with no evidence of desaturations. General anesthesia was induced with 10 mcgAEkg )1 of Atropine, 0.2 mgAEkg )1 of Etomidate, and 1.5 mgAEkg )1 of Succinylcholine. The airway was secured rapidly and the infant was placed on 1% Sevoflurane and 50% FiO 2 . The procedure was completed in approximately 15 min with no invasive monitors, and the patient was extubated at the end of the procedure. The infant was transferred to the pediatric intensive care unit as a precaution and discharged home 2 days later. CORRESPONDENCE 995