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I think that the answer to this questions depends on where you are and your
access to resources.  If you are in a resource poor setting and do not have
access to skilled sonography, then I think that x rays (3 views) would be
appropriate initial test.  Also, I think that if the symptoms have been
going on long enough or the clinical scenario suggest surgical abdomen,
then single view, upright for free air would be adequate.

But for most of us, we are in tertiary or quaternary care settings and the
US is diagnostic and reduces time to reduction...pt can be taking right
over for reduction enema with or without surgical observation (another
discussion).
Mike Falk
NY, NY


Couple of good papers to go with...the 2nd one is using 3 views and suggest
very strong predictive and diagnostic value if US not readily available.

http://www.ncbi.nlm.nih.gov/pubmed/23364378

http://www.ncbi.nlm.nih.gov/pubmed/18007208

On Mon, Jan 19, 2015 at 9:57 AM, jennifer marin <
[log in to unmask]> wrote:

> We are interested in ED practices regarding routine plain radiographs
> obtained prior to radiology ultrasounds for patients with suspected
> intussusception.
> Specifically, are you required to get an x-ray before an ultrasound will
> be done (i.e. to evaluate for free air)?
> Thanks for everyone's input.
> Jennifer Marin, MD, MScChildren's Hospital of Pittsburgh
>
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