A 9 month old male presented with recurrent episodes of screaming and abdominal pain. On examination, the physician noted a sausage-shaped mass in the right upper quadrant of the abdomen. Imaging showed signs consistent with intussusception, including a target or crescent shape mass. The patient was given IV fluids and recommended for an air contrast enema to diagnose and potentially treat the suspected intussusception.

2.  9 month old white male T: 99.4 P 110 RR 30 BP: 90/60
presents with his Gen: normal appearing . NAD
HEENT: PERRL, NCAT,
mother. She states that
oropharynx clear
he was playing earlier CV: RRR, no m/r/g
today when suddenly he Pulm: CTAB
began screaming in Abdomen: sausage-shaped mass
pain, followed by an in RUQ, NT, ND
episode of calmness. Ext: 2+ pulses, No c/c/e
This has recurred
multiple times over the
past few hours.

4. 1- Crescent Sign:
intussusception lead
point into gas filled
lumen
2- Target Sign:
Mass in RUQ forms
shape of target,
sometimes just
appears as a mass.
3- Absent RUQ bowel gas
4- Signs of small bowel
obstruction

5.  IV & IV fluids
 If H&P convincing for Intussusception:
 Air Contrast Enema
 Notify Surgery prior to study due to risk of perforation
 This can be both diagnostic and curative
 If H&P is not convincing but still in differential
 Ultrasound 1st then Air contrast enema if indicated
 This is done as a less invasive method to look for
intussusception and other causes of abdominal pain.
 Admit to hospital
 Recurrence rate of intussusception is 5-10%

6.  Most common intestinal obstruction between 3
months and 6 years of age
 “Currant Jelly Stool” is a late manifestation that is only
present in 50% of cases ; (75% have heme-positive
stool)
 Should raise concern for intussusception if present but
should have no bearing on decision if absent.
 Air contrast enema is both diagnostic and curative
 Air is preferred over contrast b/c if perforation occurs no
barium introduced into peritoneum

7.  In Left image,
Note the
outline of
bowel
telescoping
proximally.

8.  King, Lonnie. Pediatrics, Intussusception.
http://emedicine.medscape.com/article/802424-
overview
 Tintanelli’s Emergency Medicine: A Comprehensive
Study Guide. Chapter Chapter 127 Pediatric
Abdominal Emergencies
 Wahba, Mark. The Pediatric Abdomen:
Intussusception. www.remergs.com. Oct 9, 2003
 http://www.nlm.nih.gov/medlineplus/ency/imagepag
es/1172.htm