A detailed patient and symptom history, together with a physical exam on the baby, may reveal a sausage-shaped mass in the abdomen, which suggests intussusception. Additional tests may help diagnose intussusception, including an abdominal X ray. If the diagnosis is certain and the child seems to be very sick or is losing blood, the pediatric surgeon may decide to operate right away to correct the bowel obstruction. if the diagnosis is still uncertain after regular X rays and a surgical examination and the baby is not seriously ill, a barium or air enema may be prescribed. A barium enema is a special X ray in which a substance called barium is put in the baby's rectum, and several X rays are taken. Barium can outline a telescoping intestine, and the obstruction may be cured by the pres sure from placing the enema in the bowel. A rectal air enema can be used together with X rays to make the final diagnosis, but not many hospitals use them on children.

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