Summary

• Intussusception should be considered in young children with abdominal pain, particularly when clinical signs are non-specific or vague. 

• Ultrasound has excellent diagnostic accuracy for intussusception and POCUS was not significantly different from radiology-performed ultrasound. It is a good “rule in” test in the ED. 

• The “Inverted U” technique provides a systematic approach to scanning the abdomen and increases the likelihood of identifying ileocolic intussusception. 

• Always confirm abnormal findings in two planes, measure transverse diameter, and use color Doppler to assess perfusion. 

• Key ultrasound findings of intussusception: 

“Target” or “doughnut” sign (>2.5–3 cm in diameter for ileocolic) — Transverse view

 “Pseudokidney” or “sandwich” appearance  — Longitudinal view

• Normal bowel differentiation: 

Small bowel: smaller calibre, fluid-filled, peristalsis present 

Large bowel: larger calibre, gas/stool-filled, haustral folds, minimal peristalsis 

• Early identification and expedited management of intussusception via POCUS can reduce ED length of stay and improve outcomes.