Unsuccessful attempt to reduce intussusception by pneumatic enema, complicated by bowel perforation

Five-month-old boy undergoing pneumatic enema reduction for intussusception.
(A) The rectum and colon are distended with air, and the intussusception is identified as a persistent soft tissue meniscus density in the region of the cecum (asterisk). There is no air in the ileum and distal small bowel, indicating that the intussusception has not been reduced.
(B) Nonreducible intussusception (asterisk) complicated by bowel perforation during pneumatic enema reduction attempt. There is diffuse pneumoperitoneum/free air, which is best seen as a rim of lucency around the liver surface (arrowheads).