What is the first-line treatment for intussusception in a child?

• A. Pneumatic Enema (air)
• B. Surgical reduction
• C. IV antibiotics
• D. Observation and fluids

Answer: (A)

Nonoperative reduction with a pneumatic (air) enema under imaging guidance is the first-line treatment for pediatric intussusception when the child is stable and there are no signs of perforation or peritonitis. This approach both diagnoses and treats by using controlled air pressure to unfold the telescoped bowel, often resolving the problem without surgery. It has a high success rate and avoids the risks of an operation. If this enema reduction succeeds, the child is monitored afterward for recurrence. If it fails or if there are signs of perforation or peritonitis, surgical reduction is then indicated. IV antibiotics aren’t the initial treatment for uncomplicated cases and observation with fluids alone does not resolve the telescoped segment.