Paediatric radiology: practice question

A Radiology 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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Radiology · Paediatric radiology

Sample item

A 9-month-old infant has episodic colicky pain with drawing up of the legs and passes currant-jelly stool. He is haemodynamically stable with no peritonitis, and ultrasound shows a target sign. What is the best next step?

AImage-guided air or liquid enema reductionBBarium meal and follow-throughCImmediate laparotomyDObservation with repeat ultrasound in a week

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

The answer and the reasoning

A. Image-guided air or liquid enema reduction

The target (doughnut) sign on ultrasound indicates intussusception, which is most often ileocolic. In a stable child without peritonitis or perforation, image-guided air or liquid enema is both diagnostic and therapeutic. Surgery is for failed reduction or complications.

Option by option

A. Image-guided air or liquid enema reduction (correct)
Correct. Enema reduction is the first-line treatment in a stable child without peritonitis.
B. Barium meal and follow-through
A barium meal and follow-through does not reduce the intussusception and delays treatment.
C. Immediate laparotomy
Laparotomy is reserved for peritonitis, perforation or failed enema reduction.
D. Observation with repeat ultrasound in a week
Waiting a week risks bowel ischaemia and perforation.

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 Radiology question

What is the answer to this Radiology question?

The best answer is A, Image-guided air or liquid enema reduction. The target (doughnut) sign on ultrasound indicates intussusception, which is most often ileocolic.

Why is "Barium meal and follow-through" not the answer?

A barium meal and follow-through does not reduce the intussusception and delays treatment.

Why is "Immediate laparotomy" not the answer?

Laparotomy is reserved for peritonitis, perforation or failed enema reduction.

Why is "Observation with repeat ultrasound in a week" not the answer?

Waiting a week risks bowel ischaemia and perforation.

What concept does this question test?

It tests Paediatric radiology in Radiology. In a stable child without peritonitis or perforation, image-guided air or liquid enema is both diagnostic and therapeutic. Surgery is for failed reduction or complications.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 radiology?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology 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.