Snapshot A young mother brings her 2-year-old son to the pediatrician reporting that he has had recurrent "belly aches" for the past two weeks. The child experiences sudden, intermittent vomiting interspersed with periods of no complaints. The mother reports that she has seen him squatting with his knees to his chest, which seems to relieve him of his symptoms. Introduction Most common form of bowel obstruction in children Luminal lesion usually serves as focus point for looping bowels Involves the terminal ileum telescoping into the proximal large bowel in most cases ETIOLOGY Etiology unknown Associated with login to view 6 more bullets Epidemiology Most common in children 3 mos to 3 years of age Uncommon in adults Occurs in the large bowel Presentation Symptoms login to view 8 more bullets Physical exam login to view 4 more bullets Imaging Abdominal radiography login to view 2 more bullets Ultrasound login to view 2 more bullets STUDIES Labs login to view 1 more bullet Pneumatic decompression enema via fluoroscopy login to view 3 more bullets Hydrostatic decompression enema via fluoroscopy login to view 4 more bullets Differential Small bowel obstruction, upper or lower GI bleed, mesenteric ischemia Treatment Prevention login to view 1 more bullet Non-surgical management login to view 5 more bullets Surgical intervention login to view 5 more bullets Complications Bowel necrosis, followed by sepsis and death if left untreated Prognosis Very good to excellent if identified and treated early