 Good morning, myself Dr. Harshita Shetty. I am a second year radiology resident from KEM Hospital, Mumbai. I'll be presenting a case of indirect inguinal hernia, complicated by intrusception within the herniated bobble loop, causing acute intestinal obstruction in an infant. A two-month-old baby boy was brought to the pediatric emergency department with the complaints of swelling on the scrotum since morning, associated with inconsolable crying. The baby had not passed through since morning. On local examination, there was a form, tense swelling extending till the bottom of the scrotum on the left side. The baby was referred for an emergency ultrasound examination. On ultrasound examination, there was herniation of a loop of the small bobble through a defect in the inguinal region into the inguinal canal and reaching up to the upper pole of the left testis. Within this loop, there was protrusion of another loop of the small bobble, giving the bobble within bobble or the target sign appearance suggestive of ilio-ilial intrusception. 1.8 cm of the ilium was seen telescoping into the distal herniated ilial loop, giving rise to ilio-ilial intrusception in the hernial sac. The lead point was the neck of the sac. The hernial sac had a narrow neck at the deep inguinal ring, measuring 6 mm. The bobble wall was edematous, measuring 3.3 mm. However, the vascularity of the bobble walls was well maintained. The left testis and epidemis were congested and bulky as compared to the right side due to venous congestion caused due to the herniating bobble loops. The right testis measures 5.7 into 7.2 mm, while the left testis measures 10 into 10 mm. The left testis is hyperequic and bulky as compared to the right testis and mild separated hydrocele was seen on the left side. The proximal small bobble loops in the abdomen were dilated up to 2.2 cm and showed two and four peristaltic movements suggestive of intestinal obstruction. The transition point was noted at the neck of the sac. A diagnosis of left indirect inguinal hernia complicated by intraception within the herniated bobble loop causing acute intestinal obstruction was made. The child was referred to pediatric surgery department where reduction of the hernia was attempted. A repeat ultrasound examination showed persistent ilioilyl intraception with similar length of the intraceptum. Reduction was attempted again with sedation so as to achieve abdominal muscle relaxation and the baby was sent for another ultrasound examination. Local examination showed that the swelling over the left scrotum had subsided. The left scrotal sac showed a bulky and edematous testis and epididymis with increased vascularity as compared to the right side due to itchemia by venous outflow obstruction caused by the herniated contents. However, no bobble loops were noted in the scrotal sac. The left testis and epididymis are bulky and with increased vascularity as compared to the right side. The left deep inguinal ring measures 6 mm. However, no bobble loops are seen herniating through it into the inguinal canal at present. The bobble loops in the abdomen are also undilated under measure 5 mm. The baby had started passing stools by now signifying that the obstruction is relieved. The baby underwent an elective laparoscopic bilateral inguinal hernia repair the next day. A repeated ultrasound examination was performed two days after the surgery which shows that the edema and congestion of the left testis had also normalized and the baby was discharged. So, intrususception is telescoping of one segment of the bobble into another segment which is caused due to a lead point like hyperplasia of the lymphoid tissue in paeous patches, polyps, tumors or meccals diverticulum. In this case, the intrususception was induced by the inguinal hernia. There are very few case reports on the association of intrususception with internal hernias like paragonal hernia, paracycal hernias and high ethyl hernia. Only two cases of terminal eyelid intrususception in the hernia sac of inguinal hernia have been deported in adults. There is no such case in literature reported in children. Inguinal hernia repair is one of the most common surgeries which is performed. However, unusual contents can be seen in the hernial sac which include appendix, fallopian tube and ovary. Intrususception can also be noted very rarely in the hernial sac of inguinal hernia as reported in our case which can in turn to acute intestinal obstruction even though the neck of the hernia is white. It is important to detect it early so that prompt management can be done and further complications are prevented. These are my references. Thank you very much.