Distinguishing life-threatening causes of vomiting and diarrhea in infants is challenging. The ability to quickly and accurately differentiate causes of the acute abdomen at the bedside without radiation exposure is an extremely valuable skill. Ultrasound is quickly becoming first line for many differentials of the acute abdomen including intussusception, appendicitis, and pyloric stenosis. Volvulus and mesenteric adenitis can also often be seen. This report details a case of pediatric intussusception diagnosed in the emergency department by emergency medicine clinicians. Additionally, we review the best technical approach to finding an intussusceptions using ultrasound. The sensitivity and specificity of ultrasound for intussusception approaches 100% with an experienced sonographer. Harnessing this skill has the potential to save a significant amount of time and lives.

An otherwise healthy 7-year-old male presented to the emergency department complaining of a pruritic, red rash with that had increased in area over 7 days. The rash reportedly began as a localized lesion on his left lower extremity and developed a secondary diffuse rash over the trunk and upper extremities after the initial ED encounter. During the initial emergency department visit he was prescribed diphenhydramine and topical hydrocortisone with minimal relief. He denied any known environmental or allergen exposures orasthma history suggesting atopic dermatitis, or new exposures to medications. The patient and his parent also denied fever, lymphadenopathy, or any respiratory signs and symptoms. The leg lesion was not indurated or fluctuant to suggest underlying abscess. There were no other ill contacts or family history of similar rashes.