In paediatric intussusception, which imaging modality is both diagnostic and therapeutic as first-line management in a haemodynamically stable child?

• A Ultrasound-guided hydrostatic enema (or air enema) reduction ✓
• B Plain abdominal X-ray followed by emergency laparotomy
• C CT abdomen with contrast for diagnosis followed by operative reduction
• D MRI abdomen for diagnosis followed by enema reduction

Explanation

In haemodynamically stable children with intussusception, pneumatic (air) or hydrostatic enema under ultrasound or fluoroscopic guidance is both diagnostic and therapeutic. Success rates of 80–90% are reported. Ultrasound is the preferred initial diagnostic modality (showing 'target sign' / 'pseudokidney sign') and can guide hydrostatic reduction. Contraindications to enema reduction include peritonitis, perforation, or haemodynamic instability — these require emergency laparotomy. Recurrence rate after enema reduction is 5–10%, with repeated enema reduction attempted for first recurrence.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.