A 9-month-old infant presents with sudden onset colicky abdominal pain (paroxysmal episodes of crying, drawing up knees), vomiting, and passing 'red currant jelly' stools. Ultrasound shows a 'target sign' in the right iliac fossa. What is the initial treatment of choice?
- A Air enema (pneumatic reduction) under fluoroscopic guidance ✓
- B Immediate surgical laparotomy and manual reduction
- C Barium enema reduction
- D Intravenous hydration and await spontaneous resolution
Explanation
Intussusception (most common ileocolic) in a hemodynamically stable child without features of peritonitis, perforation, or prolonged obstruction (>48 hours) is first managed with non-surgical reduction. Air enema (pneumatic reduction) under fluoroscopic guidance is the current standard with >85% success rate and fewer complications than barium enema. Barium enema was previously used but is now replaced by air enema. Surgical reduction is reserved for failed enema reduction (2–3 attempts), peritonitis, perforation, or hemodynamic instability. Spontaneous resolution is rare and should not be awaited.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.