Background/Objectives: Mild traumatic brain injury (mTBI) is a leading cause of pediatric emergency department visits, particularly among children under three years old. Although computed tomography (CT) is the gold standard for diagnosing intracranial injuries, its use in young children poses radiation risks. Identifying reliable clinical indicators that justify CT imaging is essential for optimizing both patient safety and resource utilization. Objective: This study aimed to evaluate CT findings in children under three years of age with mTBI and no focal neurological deficits, as well as to identify clinical predictors associated with skull fractures and intracranial injuries. Methods: A retrospective analysis was conducted on 224 children under 36 months who presented with mTBI to a tertiary pediatric hospital from July 2019 to July 2024. Demographic data, injury mechanisms, clinical presentation and CT findings were evaluated. Univariate and multivariate regression analyses were performed to identify risk factors associated with skull fractures and intracranial injuries. Results: Falls accounted for 96.4% of injuries, with the majority occurring from heights of 0.5–1 m. The parietal region was the most frequently affected site (38%). Skull fractures were present in 46% of cases and were primarily linear (92.8%). Intracranial hematomas were identified in 13.8% of cases, while brain edema was observed in 7.6%. Significant predictors of skull fractures included age under 12 months (p < 0.001), falls from 0.5–1 m (p = 0.005), somnolence (p = 0.030), scalp swelling (p = 0.001) and indentation of the scalp (p = 0.016). Parietal bone involvement was the strongest predictor of both skull fractures (OR = 7.116, p < 0.001) and intracranial hematomas (OR = 4.993, p < 0.001). Conversely, frontal bone involvement was associated with a lower likelihood of fractures and hematomas. Conclusions: The findings highlight key clinical indicators that can guide decision-making for CT imaging in children with mTBI. Infants under 12 months, falls from moderate heights and parietal bone involvement significantly increase the risk of fractures and intracranial injuries. A more refined diagnostic approach could help reduce unnecessary CT scans while ensuring the timely identification of clinically significant injuries.

Introduction. Waugh syndrome (WS) is a rare condition characterized by association of intussusception and gut malrotation. Due to non-operativne management for intussusception in certain number of patients, it still remains undiagnosed. So far, only less than hundred casses have been reported in literature, most of them treated surgicaly, with good outcome and no complication if surgery is done timely after symptoms appeared. Case presentation. We present a five month old infant which was admited due to vomiting, blood and mucus in stool. Clinical findings revealed abdomen which was painful on palpation, without distension and abdominal mass. Blood and mucus were noted on rectal examination. After native X ray, abdominal ultrasound was done and confirmed intussusception. After unsuccessful attempt of hydrostatic reduction, ultrasound was repeated, the target sign persisted, this time accompanied by obvious “whirlpool sign” and inverse ratio of superior mesentery artery and vein. Infant underwent emergency surgery, and bowel resection with ileo-colic T-T anastomosis. Recovery was complete after two weeks. Conclusion. Waugh syndrome should be considered whenever hydrostatic reduction fails in a patient with previously diagnosed intussusception, and ultrasound verification of the superior mesenteric artery and vein relationship should be insisted upon to confirm the diagnosis off associated malrotation. In proven Waugh syndrome, timely surgical intervention is indicated to prevent bowel resection.