Intussusception is relatively uncommon, occurring in 0.5 to 2.3 cases per 1,000 live births in the USA. Radiology residents, therefore, have few opportunities to participate in intussusception reduction during training, and practicing radiologists encounter it infrequently. Training is essential, as successful reduction avoids surgery. The judgment involved in reducing an intussusception is best gained with experience. We developed a training device that simulates fluoroscopic intussusception reduction with air. The device consists of a doll that contains a cylinder with similar stress and strain characteristics to the human colon. The trainee pumps air into the cylinder through a rectal tube using a standard hand-held air reduction pump. A sensor measures the pressure within the chamber and transmits readings to a computer, which displays images from actual intussusception reductions based on the pressure maintained within the device. A random component in the software gives the user a new experience each time and models uncertainties in the actual reduction process, including perforation. This intussusception reduction simulator can enhance resident education, giving residents the opportunity to practice this technique before employing it on a real patient. The simulator can also help practicing radiologists become more comfortable with intussusception air reduction.Electronic supplementary materialThe online version of this article (doi:10.1007/s00247-010-1764-x) contains supplementary material, which is available to authorized users.

Objectives: Intussusception, an uncommon but important cause of acute abdomen during infancy and early childhood, can be safely and effectively treated by fluoroscopic air reduction. Although pediatric radiology fellows report ample opportunity to practice intussusception reduction, radiology residents report few opportunities to participate in this procedure. Adequate training to reduce intussusception is essential, as successful reduction obviates the need for surgery. A teaching device that simulates intussusception reduction could help radiology residents develop the skills necessary to perform this procedure. Materials and Methods: We report on improvements made to a training device developed in 2010 by Stein-Wexler et al. Since then we have simplified the manufacturing process, added several unique patient cases, improved the software so that adding patient scenarios is easier, and improved the graphic interface to make the simulation more realistic and facilitate feedback. Results: The simulator is now a customizable and robust standalone package. A thorough instructor's manual and improvements to the graphic design-such as embedded checklists, built-in feedback mechanisms, and a more intuitive interface-make the simulator easier to use. Conclusion: We have improved our previously-reported teaching device for intussusception reduction and produced a robust simulator. We plan to make this device available to programs that train physicians in pneumatic intussusception reduction.