The comparison between POCUS, X-ray, and CT for intussusception diagnosis in children involves three factors: accuracy, radiation, and time. Plain abdominal X-ray has poor sensitivity for intussusception - it may show features suggestive of bowel obstruction in advanced cases, but in the early presentation, when intervention is most effective, the X-ray is frequently normal or shows only non-specific bowel gas patterns. A normal X-ray does not exclude intussusception. CT scanning of the abdomen does diagnose intussusception accurately, but it delivers a significant radiation dose to a young child's abdomen and pelvis - radiation that carries a long-term cancer risk that is small but real and is clinically unjustifiable when an equally accurate, radiation-free alternative is available. CT also requires the child to be moved from the emergency area, potentially distressing an already unwell infant, and may require sedation. POCUS at the bedside, when performed by an experienced examiner, has sensitivity and specificity for intussusception that is comparable to formal ultrasound. It requires no radiation, no patient transport, no sedation, and no delay. The result is available immediately and the management decision follows within the same assessment. In the context of paediatric emergency care in Varanasi, where the decision to observe versus refer for immediate enema reduction versus prepare for surgery may need to be made within the first hour of a child's arrival, POCUS gives the clinical team the information needed to make that decision without delay.
Written by Dr. Chhaya Pathak, MBBS, MD (Pediatrics), Senior Consultant Paediatrician, Neonatologist and Intensivist, Pioneer of Paediatric POCUS in Eastern Uttar Pradesh, Co-Founder, Vatsalya Children's Hospital, Mahavir Road, Orderly Bazar, Varanasi, Uttar Pradesh 221002. 40+ years, 1,00,000+ patients. Phone: +91 9838585111.
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