Background: Ankylosing spondylitis, a chronic and infl ammatory disease, is known as a very serious pathology, which basically is the diffi culty in airway management and respiratory and cardiac problems in terms of anesthesia. In this case report, we aim to present an uncommon anesthesia experienced in an ankylosing spondylitis patient, who required percutaneous nephrolitotomy due to Staghorn type kidney stone.
Case Report: A 47-year-old heavy smoker male patient who had been diagnosed with ankylosing spondylitis is scheduled for PCNL because of a Staghorn type stone in the left kidney. He has a difficult airway with a Mallampati IV score and pulmoner dysfunction in restrictive type. Due to skeletal deformity, giving a prone-surgical position was also very diffi cult for the patient.
Conclusions: We decided that for an ankylosing spondylitis patient, PCNL can be a safe surgical approach, if the patient is carefully evaluated preoperatively, if required preparations are made for airway difficulty, and if an attentive anesthesia plan - regarding the patient position in particular and ventilation problems- is applied.

Keywords: percutaneous nephrolithotomy, Ankylosing spondylitis, difficult airway