Question 2571
{"accessible":false,"alternatives":[{"id":12608,"text":"pneumoperitoneum"},{"id":12609,"text":"shock"},{"id":12610,"text":"small bowel obstruction"},{"id":12611,"text":"peritonitis"}],"archived":false,"correctAlternativeId":12610,"explanation":"\u003cp\u003ePneumoperitoneum, shock, and peritonitis are contraindications to attempting enema reduction.\u003c/p\u003e\u003cp\u003eSmall bowel obstruction may reduce the chances of successful enema reduction, but is not a contraindication in the right clinical context.\u003c/p\u003e\u003cp\u003eOther findings associated with a reduced chance of successful enema reduction include:\u003c/p\u003e\u003cul\u003e\n\u003cli\u003e\u003cp\u003e\u0026gt;48 hours of symptoms\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003eage \u0026lt;3 months or \u0026gt;5 years\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003efluid trapped in the layers of the intussusception on ultrasound\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003eno vascular flow within the intussusceptum\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003ea pathological lead point\u003c/p\u003e\u003c/li\u003e\n\u003c/ul\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eReferences:\u003c/p\u003e\u003col\u003e\n\u003cli\u003e\u003cp\u003eCogley J, O’Connor S, Houshyar R, Dulaimy K. Emergent Pediatric US: What Every Radiologist Should Know. Radiographics. 2012;32(3):651-65. \u0026lt;a href=\"\u003ca href=\"https://doi.org/10.1148/rg.323115111%22\u003edoi:10.1148/rg.323115111\u003c/a\u003e\"\u003ehttps://doi.org/10.1148/rg.323115111\"\u0026gt;doi:10.1148/rg.323115111\u0026lt;/a\u0026gt;\u003c/a\u003e - \u0026lt;a href=\"\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22582352%22\u003ePubmed\u003c/a\u003e\"\u003ehttps://www.ncbi.nlm.nih.gov/pubmed/22582352\"\u0026gt;Pubmed\u0026lt;/a\u0026gt;\u003c/a\u003e\u003c/p\u003e\u003c/li\u003e\n\u003cli\u003e\u003cp\u003eHannon E, Allan R, Negus A, Murphy F, Okoye B. Air Enema Reduction of Intussusception: A Registrar-Led, Protocol-Driven Service is Safe and Effective. Pediatr Surg Int. 2013;29(8):805-9. \u0026lt;a href=\"\u003ca href=\"https://doi.org/10.1007/s00383-013-3328-2%22\u003edoi:10.1007/s00383-013-3328-2\u003c/a\u003e\"\u003ehttps://doi.org/10.1007/s00383-013-3328-2\"\u0026gt;doi:10.1007/s00383-013-3328-2\u0026lt;/a\u0026gt;\u003c/a\u003e - \u0026lt;a href=\"\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23732829%22\u003ePubmed\u003c/a\u003e\"\u003ehttps://www.ncbi.nlm.nih.gov/pubmed/23732829\"\u0026gt;Pubmed\u0026lt;/a\u0026gt;\u003c/a\u003e\u003c/p\u003e\u003c/li\u003e\n\u003c/ol\u003e","id":2571,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2643","nextQuestionPath":"/articles/small-bowel-obstruction/questions/2474","relatedArticles":[{"id":1526,"title":"Intussusception","link":"/articles/intussusception?lang=us"},{"id":6165,"title":"Pneumoperitoneum","link":"/articles/pneumoperitoneum?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eA 3-year-old child with ultrasound-diagnosed intussusception is being considered for air enema reduction.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eWhich of the following is \u003cstrong\u003eNOT\u003c/strong\u003e a contraindication for air enema reduction?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2571"}],"attemptsPercentages":[{"alternativeId":"12610","percentage":79},{"alternativeId":"12609","percentage":6},{"alternativeId":"12611","percentage":8},{"alternativeId":"12608","percentage":6}],"promptToLogin":false,"questionManager":false,"articleId":"small-bowel-obstruction"}