A 9-month-old infant presents with sudden colicky crying, currant-jelly stools, and a palpable right upper quadrant mass. Ultrasound shows a 'target sign' (pseudokidney sign) in the right upper quadrant. The BEST approach for reduction is:
- A Air or water-soluble contrast enema reduction under fluoroscopy/US guidance ✓
- B Immediate surgical reduction
- C Barium enema reduction
- D Observation and intravenous fluids
Correct answer: A. Air or water-soluble contrast enema reduction under fluoroscopy/US guidance
Explanation
Ileocolic intussusception in infants is best managed initially by pneumatic (air) or hydrostatic (saline or water-soluble contrast) enema reduction under fluoroscopic or ultrasound guidance. Success rates are 80–95% for uncomplicated cases. Barium is no longer used due to risk of barium peritonitis if perforation occurs. Surgical reduction is reserved for failed enema reduction, peritonitis, bowel ischaemia, or perforation. Air enema is preferred over hydrostatic due to better success rates and lower perforation risk.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.