A 2-year-old child presents with sudden onset of colicky abdominal pain, passage of 'redcurrant jelly' stools, and a sausage-shaped mass in the right iliac fossa. Which of the following is the preferred initial treatment?

• A Emergency laparotomy and manual reduction
• B Pneumatic (air) or hydrostatic (saline/contrast) enema reduction under fluoroscopic or ultrasound guidance ✓
• C IV morphine and NGT decompression followed by observation for 12 hours
• D Diagnostic colonoscopy and manual endoscopic reduction

Explanation

Intussusception in children is first managed with non-surgical pneumatic (air enema) or hydrostatic (saline/contrast enema) reduction under fluoroscopic or ultrasound guidance, with success rates of 80-95% in uncomplicated cases. Contraindications include peritoneal signs, perforation, or haemodynamic instability, which mandate surgery. The classic triad is colicky pain, palpable abdominal mass, and redcurrant jelly stools (blood-stained mucus). The most common site is ileocolic. Surgical reduction or resection is reserved for failed non-surgical attempts or complicated cases.

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.