Is ilioinguinal/iliohypogastric nerve block always totally safe in children?

• Published in: Pediatric anesthesia Vol. 13; no. 2; pp. 164 - 166
• Main Authors: Amory, C., Mariscal, A., Guyot, E., Chauvet, P., Leon, A., Poli‐Merol, M.L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.02.2003; Blackwell
• Subjects: accidental puncture of the bowel; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; children; Hernia, Inguinal - surgery; Humans; ilioinguinal nerve block; inguinal surgery; Intestine, Small - injuries; Local anesthesia. Pain (treatment); Male; Medical sciences; Nerve Block - adverse effects; peripheral blocks; Human; Peripheral nerve; Perforation; inguinal surgery; peripheral blocks; Blocking; Herniorrhaphy; Inguinal; Small intestine; Case study; Hernia; ilioinguinal nerve block; Regional anesthesia; accidental puncture of the bowel; children; Surgery; Disease of the small intestine; Digestive diseases; Intestinal disease; Complication; Child
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1046/j.1460-9592.2003.01005.x

Summary We report a case of accidental puncture of the small bowel during an ilioinguinal/iliohypogastric nerve block procedure for hernia repair. The diagnosis was made a few days later during a laparoscopic exploration owing to the progressive onset of clinical and radiological intestinal obstruction. A large, obstructing subserosal haematoma was found without any apparent perforation of the mucosa, and the damaged loop was resected. Such a complication has already been reported once in the literature after use of a long bevel needle for the puncture. This case is the first reported using an atraumatic short bevel needle. We discuss the technical aspects of the procedure and underline the fact that regional anaesthesia in children is never totally risk free.