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The authors developed a bedside nomogram using routine ultrasound to predict irreducible SBI in 484 children (47 irreducible, 9.7%). LASSO regression selected five predictors: bloody stool, intussusception diameter and length, bowel wall thickness, and Doppler flow grade. The nomogram demonstrated good discrimination (C-index 0.907, 95% CI 0.869\u20130.945) and favorable calibration. 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