Paediatric surgery: intussusception reduction: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: intussusception reduction

Sample item

A 9-month-old boy has episodic screaming with drawing up of the legs and passes red currant jelly stool. He is haemodynamically stable with no peritonitis, and ultrasound shows a target sign in the right abdomen. What is the best treatment?

AImage-guided air enema reductionBOral antibiotics and observationCBarium swallow follow-throughDImmediate laparotomy and resection

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Image-guided air enema reduction

Ileocolic intussusception is the commonest type in infants, and most cases have no pathological lead point. In a stable child without peritonitis or perforation, hydrostatic or pneumatic (air) enema reduction under radiological guidance succeeds in most cases. Surgery is for failed reduction, peritonitis or perforation.

Option by option

A. Image-guided air enema reduction (correct)
Correct. Non-operative pneumatic reduction is first-line in a stable child.
B. Oral antibiotics and observation
Observation risks bowel ischaemia and perforation.
C. Barium swallow follow-through
Contrast follow-through does not reduce the intussusception and is not appropriate.
D. Immediate laparotomy and resection
Surgery is needed when reduction fails or there is peritonitis or shock.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Image-guided air enema reduction. Ileocolic intussusception is the commonest type in infants, and most cases have no pathological lead point.

Why is "Oral antibiotics and observation" not the answer?

Observation risks bowel ischaemia and perforation.

Why is "Barium swallow follow-through" not the answer?

Contrast follow-through does not reduce the intussusception and is not appropriate.

Why is "Immediate laparotomy and resection" not the answer?

Surgery is needed when reduction fails or there is peritonitis or shock.

What concept does this question test?

It tests Paediatric surgery: intussusception reduction in General Surgery. In a stable child without peritonitis or perforation, hydrostatic or pneumatic (air) enema reduction under radiological guidance succeeds in most cases. Surgery is for failed reduction, peritonitis or perforation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: intussusception reduction?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.