Difficult ventilation from increased abdominal pressure.

Airway management is one of the most important responsibilities of every anesthesiologist. A problematic situation arises when a patient is intubated correctly but not being ventilated. A case of a 4-year-old child who was involved in a car accident, presented for an exploratory laparotomy. Although she was successfully intubated, she could not be ventilated. The situation only improved after a large volume of fluid (urine) was drained from the abdomen.