The abdominal x-ray shows evidence of small bowel obstruction with dilated loops of small bowel located centrally. This finding supports the clinical diagnosis of intussusception in this patient.

The patient was noted to have an ileocolic intussusception on ultrasound and was successfully treated with air enema.

What is the role of abdominal x-ray in a pediatric patient with suspected intussusception?

• Plain abdominal x-ray can be normal in a child with intussusception.
• Role of plain x-ray in the diagnosis of intussusception is controversial.
• Abdominal x-ray may show evidence of bowel obstruction as in this case. Free intraperitoneal air may be visible if there has been intestinal perforation.
• X-ray findings specific to intussusception are – target sign (soft tissue density with two concentric circles), absent liver edge sign (soft tissue density from the intussusception resting on the liver edge), crescent sign (leading edge of the intussusception outlined by gas in the colon forming a crescent).

Reference: https://www.hawaii.edu/medicine/pediatrics/pedtext/s10c04.html