A 6-year-old boy presents with an ileocaecal intussusception confirmed on ultrasound (target sign). There are no features of peritonitis or perforation. What is the first-line treatment?
- A Emergency surgical reduction via laparotomy
- B Conservative management with IV fluids and observation
- C Air enema reduction under fluoroscopic or ultrasound guidance ✓
- D Laparoscopic reduction
Correct answer: C. Air enema reduction under fluoroscopic or ultrasound guidance
Explanation
For paediatric ileocaecal intussusception without peritonitis or perforation, pneumatic (air) or hydrostatic (saline/contrast) enema reduction under imaging guidance is the standard first-line treatment, achieving successful reduction in 75-90% of cases. Success rate is higher in children <2 years with shorter symptom duration. Surgery (laparoscopic or open) is reserved for failed non-operative reduction or cases with perforation/peritonitis. Air enema has replaced barium due to lower risk if perforation occurs.
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.