The clinical study on conservative therapy of pediatric intussusception: caudal block improves the success rate

Intussusception is the most cause of obstruction in infants, with an incidence of 2 to 4 for 1,000 live births (1). It is the result of the invagination of the bowel into an adjacent lower segment, usually at the terminal ileum or ileocecal valve, and rarely caused by polyp or Meckel diverticulum (5% of cases). With time, intussusception leads to venous obstruction and bowel edema, which obstruct and compromise vascularity. The result of this process is a gangrenous bowel. The first signs are often paroxysmal pain, bloody diarrhea (often described as a currant jelly stool) and later vomiting (Figure 1). Therefore, it is very important to reduce an intussusception as soon as possible before complication brings about. In children with stable medical conditions, sedation is appropriate to facilitate reduction of the intussusception. This must be done cautiously with adequate resuscitative equipment and appropriate personnel nearby (2). But intramuscular or intravenous sedation do not provide enough relaxation to reduce an intussusception manually. A caudal block is commonly used to provide intraand postoperative analgesia in children (3). Original Article