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Screaming fits: Intussusception
Case presentation
A 15-month-old boy is brought into the emergency department by his parents for inconsolable crying for the last 6 hours. He has been crying and refusing to feed and has had nonbloody, nonbilious emesis twice. He is afebrile and his other vital signs are heart rate in the 160s beats per minute, respiratory rate of 30 breaths per minute, blood pressure of 107/89 mm Hg, and an oxygen saturation of 98% on room air. He is asleep and does not wake up except to grimace during his abdominal examination. There are no deformities, corneal abrasions, and other abnormalities on the rest of his examination.
Imaging considerations
Imaging modalities largely depend on institutional practices, the availability of fluoroscopy and ultrasound (US), and the experience and preference of the providers managing the patient. A prompt surgical consult is warranted in children with obvious signs of peritonitis as operative management is required. For children who are not in extremis, several imaging choices are available to clinicians.
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