A 2-year-old child presents with intermittent colicky abdominal pain, passage of 'redcurrant jelly' stools, and a sausage-shaped mass in the right upper quadrant. Abdominal ultrasound shows a target sign. What is the first-line treatment?

• A Emergency surgery for manual reduction
• B Air enema reduction under fluoroscopic or ultrasound guidance ✓
• C Barium enema reduction
• D Conservative management with intravenous fluids

Explanation

Intussusception is the most common cause of intestinal obstruction between 3 months and 5 years. The classic triad of colicky pain, redcurrant jelly stool, and sausage-shaped mass along with the ultrasound target sign (concentric rings) is diagnostic. The first-line treatment in hemodynamically stable patients without perforation is pneumatic (air) or hydrostatic enema reduction under fluoroscopic or ultrasound guidance, with a success rate of approximately 80-90%. Surgery is reserved for failed non-operative reduction, peritonitis, or perforation. Air enema has largely replaced barium enema due to its safety profile.

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.