What is the first-line diagnostic and treatment procedure for intussusception?

What is the first-line diagnostic and treatment procedure for intussusception?

• A. Pneumatic (air) enema
• B. Ultrasound examination
• C. Surgical reduction
• D. Barium enema

Answer: (A)

Intussusception in children is usually treated first with a nonoperative reduction that also helps confirm the diagnosis. A pneumatic (air) enema, guided by fluoroscopy, pushes the telescoped segment back into place and allows the clinician to see whether reduction succeeds. This approach treats the problem without surgery and has a high success rate when the intussusception is ileocolic and the bowel isn’t perforated or peritonitic. Ultrasound is excellent for confirming the diagnosis by showing the classic target sign, but it doesn’t reduce the problem. Barium enema can reduce intussusception but carries greater risk if perforation occurs and is less favored today. Surgical reduction is reserved for cases where the enema fails, there are signs of perforation or peritonitis, or recurrence after nonoperative reduction.

Intussusception in children is usually treated first with a nonoperative reduction that also helps confirm the diagnosis. A pneumatic (air) enema, guided by fluoroscopy, pushes the telescoped segment back into place and allows the clinician to see whether reduction succeeds. This approach treats the problem without surgery and has a high success rate when the intussusception is ileocolic and the bowel isn’t perforated or peritonitic.

Ultrasound is excellent for confirming the diagnosis by showing the classic target sign, but it doesn’t reduce the problem. Barium enema can reduce intussusception but carries greater risk if perforation occurs and is less favored today. Surgical reduction is reserved for cases where the enema fails, there are signs of perforation or peritonitis, or recurrence after nonoperative reduction.