A 9-month-old infant develops sudden, severe, colicky abdominal pain with drawing up of legs, currant jelly stools, and a sausage-shaped mass in the right hypochondrium. The FIRST-LINE treatment in a hemodynamically stable child without peritoneal signs is:
- A Emergency laparotomy
- B Air (pneumatic) or saline enema reduction under fluoroscopic/ultrasound guidance ✓
- C Passage of a nasogastric tube and IV antibiotics for 24 hours
- D Rectal wash-outs
Correct answer: B. Air (pneumatic) or saline enema reduction under fluoroscopic/ultrasound guidance
Explanation
Intussusception (ileocolic — the most common type in infants 6–18 months) is initially managed with pneumatic (air) or hydrostatic (saline/water-soluble contrast) enema reduction under imaging guidance, with success rates of 80–95% in non-complicated cases. This is the gold standard first-line treatment. Surgery is reserved for failed enema reduction, bowel ischemia/perforation, peritonitis, or hemodynamic instability. Currant-jelly stool (blood and mucus) is a hallmark feature indicating mucosal ischemia.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.