WOFAPS 2025 8th World Congress of Pediatric Surgery

ABIRAMI KRITHIGA JAYAKUMAR

RAINBOW CHILDRENS HOSPITAL, CHENNAI, INDIA

Purpose: To analyse the role and effectiveness of sedation and caudal block in enhancing the success rate of hydrostatic reduction of intussusception in children, and to identify clinical and radiological predictors contributing to failed reductions, based on the initial independent experience of a single pediatric surgeon.

Method: Medical records of 18 children who underwent ultrasound-guided hydrostatic reduction of intussusception over 2.9 years were retrospectively reviewed. Patient demographics, clinical presentation, and sonographic parameters, including type and length of intussusception, presence of a lead point, and free peritoneal fluid, were systematically analysed.

Result: The overall success rate of hydrostatic reduction was 88%. One child underwent successful reduction in the ultrasound suite without sedation. Six children were successfully reduced on the first attempt under sedation, while seven required a second attempt with caudal block, all of which were successful. Four children underwent open surgery; among them, one had a pathological lead point necessitating bowel resection and anastomosis. Factors significantly associated with failed reduction included delayed presentation, clinical signs of shock, abdominal distension, and complex sonographic types such as ileo-ileo-colic and ileo-colo-colic intussusception.

Conclusion:

Hydrostatic reduction of intussusception can be safely and effectively performed under sedation in children. The use of a caudal block significantly improves the success rate, particularly in repeat attempts. Among the factors influencing outcome, the type of intussusception, the presence of a pathological lead point, and abdominal distention emerged as the most significant predictors of failed reduction. Careful patient selection and timely intervention are key to optimizing non-operative management.