Air enema was used for exclusion, diagnosis, initial movement, and complete reduction of intussusception in 186 pediatric patients. Average pressure needed for initial movement of intussusception was 56.5 mm Hg; average maximum pressure of 97.8 mm Hg was required for complete reduction. Average fluoroscopy time required for intussusception reduction was 94.8 seconds; an average of 41.8 seconds was required to exclude intussusception. Intussusception was diagnosed in 75 patients, and reduction was accomplished in 65 (87%). Of 100 consecutive patients that underwent hydrostatic reduction of intussusception at the authors' institution, reduction was successful in 55. Compared with hydrostatic enema, air enema involves shorter fluoroscopy time and lower radiation dose to the patient. Air enema is safe and effective for diagnosis and treatment of intussusception in infants and children and has replaced hydrostatic enema for such procedures at the authors' institution.

Gastric inflammatory pseudotumors have radiographic, surgical, and histologic features that simulate malignant tumors. To avoid inappropriately aggressive therapy, it is important to know when to consider this diagnostic possibility preoperatively. The cases of two children with gastric inflammatory pseudotumors are presented to emphasize three findings in this entity: (a) An inflammatory pseudotumor should be considered if a gastric mass encompasses an ulcer or a confined gastric perforation. (b) Other unusual inflammatory responses associated with a gastric mass, such as sclerosing cholangitis and retroperitoneal fibrosis, should suggest the diagnosis. (c) Inflammatory pseudotumor is the most likely cause of a gastric mass in a child with Castleman syndrome.

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Ten cases of traumatic atlanto-occipital disruption in pediatric patients are reported. All injuries resulted from motor vehicle accidents, the majority of which were pedestrian/automobile. Three patients survived their injury for a period greater than one year. The importance of recognizing atlanto-occipital disruption is stressed because of its relative frequency in severely traumatized pediatric patients, particularly pedestrian/vehicle incidents, and because of the potential for survival. Diagnosis, in most instances, is based on the lateral cervical spine radiograph. The most applicable diagnostic features in children, as demonstrated on the lateral cervical spine radiograph, are reviewed.