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Pediatric Medicine


Answer 2
  1. Air-contrast enema. This patient has an intussusception. Air-contrast enema is both diagnostic and potentially therapeutic. CT scan results are not reliable in cases of intussusception nor is endoscopy of any value. While surgical intervention may become necessary, it is only a first step prior to air-contrast enema if perforation is likely to have already occurred. In this case, administration of an antiemetic (ie, prochlorperazine) would result in a delay in diagnosis and increased morbidity.

    SUGGESTED READING
    Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia: Saunders; 2004.

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