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Diaphragmatic hernia and eventration of the diaphragm as congenital defects have similar clinical and radiological presentations. The umbilical venous catheter is successfully used for venous access in a neonatal age group with minimal complications. We present a case of a two-day-old neonate, initially scheduled for thoracoscopic repair of right diaphragmatic hernia. But, the intraoperative evaluation revealed the right diaphragmatic eventration. After initial ventilation and optimization in the neonatal intensive care unit, the baby was taken up for thoracoscopic repair under general anesthesia. The postoperative abdominal radiograph showed migration of umbilical vein catheter into the portal vein cephalad. The possible explanation is liver reposition to standard anatomical localization upon surgical correction. The catheter was uneventfully pulled back to its optimal position.

Background and Aims: A pilot study among anesthesiologists, revealed a wide variation among individual practices including skipping pre-anesthetic airway assessment during COVID-19 pandemic because of the fear of getting infected. Risk of infection during pre-anesthetic airway assessment has not been studied. The primary objective of the survey was to evaluate the practices of airway examination by anesthesiologists during this pandemic period. Secondary objectives were to study the effects of institutional factors and other individual practices on risk modification and the incidence of COVID-19 infection among anesthesiologists., Material and Methods: A survey was conducted using a pre-validated questionnaire comprising of 35 questions. The questionnaire was circulated among 4676 members of the Indian Society of Anaesthesiologists (ISA) through Google Forms by email., Results: Of the 4676 members contacted via email, 470 were returned undelivered. From the remaining 4206 questionnaire recipients, 456 completed responses were obtained giving a response rate of 10.8%. Percentage, mean and standard deviation were calculated using EZR software. The conduct of pre-anesthetic airway assessment has decreased by 31.7% during the pandemic, leading to 5.2% of participants encountering unanticipated difficult airway. Among the respondents, eight percent were infected., Conclusion: Avoidance of preoperative airway assessment by anesthesiologists during the COVID-19 pandemic has led to rising unanticipated difficult airway undermining the patient safety. Adherence to recommended practices ensures safety from risk of COVID-19 infection., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Anaesthesiology Clinical Pharmacology.)