2 year-old male with no PMHx is brought to the ED for intermittent abdominal pain for the past two days. Mom notes that the child will crouch down into a ball when he has pain, which only lasts for a few minutes at a time. He has decreased solid food intake but no vomiting or diarrhea and is otherwise well. Vitals and physical exam are unremarkable. The ultrasound is shown below…what’s the diagnosis?

Answer:  Intussusception

• Proximal portion of bowel enters a distal portion and then is pulled further forward via peristalsis.
  
• If the intussusception remains for a long period of time, the involved bowel may become edematous and compromise blood flow; this could lead to ischemic bowel.
• Imaging may includes plain xrays demonstrating signs of bowel obstruction, but ultrasound should be considered as well. Ultrasound demonstrates the “target sign” demonstrated below

• Treatment includes an air or water-soluble contrast enema