253A CASE REPORT OF AN AIRWAY EMERGENCY DURING GENERAL ANESTHESIA IN A CHILD WITH PLASTIC BRONCHITIS AFTER FONTAN SURGERYPlastic bronchitis (PB) is a rare but potentially fatal complication that can occur after Fontan surgery, which is a palliative procedure for patients with a single functional ventricle. Plastic bronchitis (PB) is a complication of Fontan surgery, results in the formation of mucus plug in the tracheobronchial tree, causing potentially fatal airway obstruction. We report critical airway emergency during general anesthesia in a child with plastic bronchitis. Mucus plugs form in the tracheobronchial tract and can obstruct the airway, posing a life-threatening threat. A difficult anesthesia management case in a child with plastic bronchitis is presented here. Anesthetic management for bronchoscopy removal of casts can be challenging because children are often apprehensive, uncooperative, and in respiratory distress from critical airway compromise. Percutaneous catheterization was used to perform intrapulmonary lymphatic embolization on a 5-year-old boy. He had Fontan surgery when he was two years old and suffered from plastic bronchitis for the rest of his life. His family history was unremarkable, and the pregnancy went off without a hitch. Fetal echocardiography revealed heart abnormalities. We believe it is preferable to perform Fontan surgery in a facility where ECMO is immediately available in PB after Fontan surgery. Because ECMO was not available for young children in our facility, our patient was transferred to a children's hospital for safety reasons. After the transfer, the respiratory tract obstruction recurred, and ECMO was started. It has been reported that ECMO has been used in more invasive surgical treatments for PB. General anesthesia for a patient with PB should be planned with ECMO or CPB standby due to the high risk of critical airway obstruction.Selvakumar@gmail.comResearch732017Fontan Surgery,Plastic Bronchitis,Airway EmergencyDr. S. SelvakumarDepartment of General Surgery, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry – 605 502, India