What is the treatment of choice for a child with intussusception?

Choice A reason: Intussusception involves bowel telescoping, causing obstruction. A barium enema is the treatment of choice, as it applies hydrostatic pressure to reduce the invagination, restoring bowel continuity. This non-invasive method is effective in 80-90% of pediatric cases, avoiding surgical risks, and is prioritized unless perforation or peritonitis is present. Choice B reason: IV fluids support hydration in intussusception but do not address the mechanical obstruction causing bowel ischemia. Fluids manage dehydration from vomiting or reduced intake, but only a barium enema or surgery corrects the telescoping, making fluids a supportive, not primary, treatment for resolving the underlying pathology. Choice C reason: Immediate surgery is reserved for intussusception cases with perforation, peritonitis, or failed non-operative reduction. While effective, it carries risks like infection or adhesions. A barium enema is preferred as a less invasive option, successfully reducing the intussusception in most children, making surgery a secondary choice unless complications arise. Choice D reason: Gastric lavage clears stomach contents but is irrelevant for intussusception, which involves intestinal obstruction. It does not reduce the telescoped bowel or relieve ischemia. A barium enema directly addresses the mechanical blockage, making lavage inappropriate, as it fails to correct the underlying anatomical issue causing the condition.