Diagnosing Pediatric Intussusception Through Bedside Ultrasound by Novice Emergency Department Sonographers: A Case Report

Intussusception is a common cause of gastrointestinal emergency in the paediatric population and  it is usually  diagnosed through  Barium  enema  radiography or  ultrasound. The skill of using an ultrasound by a minimally trained medical  officer in diagnosing this cases in the Emergency Department are very helpful and expedite the  management. We  present  the  case  of a 7-month-old girl who  presented to Emergency Department (ED) with the chief complaint of passing  blood  in stool. Clinically  she  was  dehydrated, irritable  and  in compensated shock.  There  was generalised tenderness per  abdomen but  it was  soft  and  not  distended. There was no palpable mass and  bowel  sound  normal.  Immmediate fluid resuscitated commenced. Bedside  abdominal ultrasound performed by  ED medical  officer showed  a 1.8 cm x 2.5 cm mass of alternating hypo-echoic and hyper-echoic rings at the  right lower  quadrant, consistent  with  the  ‘target’ sign of intussusception. Supine  plain  abdominal X-ray did  not  reveal  any  abnormality. The  ultrasound finding of intussusception was later confirmed by the radiologist.  She underwent immediate hydrostatic  reduction and was discharged well.