A 7-month-old child presented to the emergency department (ED) with 2 hours
of painless, nonprojectile emesis and a normal mental status. Over a 3-hou
r period in the ED, the child remained pain-free, but developed hematemesis
, hematochezia, and lethargy, progressing to unresponsiveness, The patient
was evaluated for toxic ingestion, intracranial bleed, sepsis/meningitis, a
nd intraabdominal pathology, The diagnosis was made by an abdominal ultraso
und, which demonstrated an ileal-cecal intussusception that ultimately requ
ired surgical reduction, This case illustrates an insidious and poorly unde
rstood presentation of a common childhood affliction, as well as the utilit
y of abdominal ultrasound in evaluating a hemodynamically stable patient wi
th intussusception. Copyright (C) 1999 by W.B. Saunders Company.