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Intussusception — RACP Paediatrics MCQ

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ModerateGastroenterologyIntussusceptionRACP Paediatrics

A 9-month-old previously well infant presents with intermittent episodes of screaming and drawing up of legs, occurring every 15–20 minutes. Between episodes, the child is lethargic. A sausage-shaped mass is palpable in the right upper quadrant and 'redcurrant jelly' stool is noted on rectal examination. What is the most appropriate initial management?

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Correct answer: E — Ultrasound-guided air enema reduction

Intussusception in a haemodynamically stable child without signs of perforation or peritonitis should be treated with non-operative reduction. Air enema under fluoroscopic or ultrasound guidance is the preferred reduction technique in most Australian paediatric centres due to its safety and efficacy (>80% success rate). Surgical reduction is reserved for failed non-operative reduction or peritonitis.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Intussusception