[Invagination. The present status of diagnostic imaging and therapy]

The use of ultrasound techniques has brought about considerable changes in the diagnosis and therapy of intussusception in the past few years. (1) Whenever intussusception is suspected ultrasound examination of the abdomen is the diagnostic procedure of choice; a diagnosis of intussusception can be made or excluded with an adequate degree of accuracy. (2) Ultrasound monitoring is also good for the follow-up of cecal edema after reduction of intussusception, making it possible to check that there are no pathological lead points and that complete restoration of function has been achieved. (3) There are only three absolute contraindications for attempting an enema: peritonitis, shock, and perforation. (4) Whenever there are relative contraindications for administration of an enema, e.g., long duration of symptoms, complete small-bowel obstruction, it is of the utmost importance to inform the pediatrician and the surgeon and to discuss with them the potential benefits and risks involved in an attempt at hydrostatic reduction.