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Found 753 cases where Vaccine is RV5 and Symptom is Intussusception and Appearance Date on/before '2012-04-30'

Case Details

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VAERS ID: 274364 (history)  
Form: Version 1.0  
Age: 0.34  
Gender: Female  
Location: North Carolina  
Vaccinated:2006-12-29
Onset:2007-03-03
   Days after vaccination:64
Submitted: 2007-03-19
   Days after onset:15
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1113F / 2 - / -

Administered by: Other       Purchased by: Other
Symptoms: Intussusception, Surgery
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK records received 4/17/07-Labs: WBC 45.9, platelets 613, 53% granulocytes. Flu test negative. Urine culture negative. Stool for occult blood positive. Rotavirus stool negative. Enema positive for mid transverse colon intussusception, unable to completely reduce with enema. Histology:peripheral blood smear, normocytic anemia. thrombocytosis.
CDC Split Type: WAES0703USA01240

Write-up: Information has been received from a physician concerning a 6 month old Middle Eastern female who was vaccinated with a first and second dose of Rotavirus on 27-OCT-2006 and 29-DEC-2006, respectively. On 03-MAR-2007 the patient was hospitalized for intussusception, which required surgery, but no bowel resection. Subsequently, the patient recovered. No other information was provided. Additional information has been requested. 04/17/07-records received from facility for DOS 3/2-3/5/07 DC DX: Intussusception. Fever. Leukocytosis. 6 day HX of vomiting, has had no stool no diarrhea. Prior to admission fever 103.5. Weight down 14 ounces. Congestion with clear runny nose. Afebrile upon admission. 2nd day of admission passed mucusy stool with streaks of blood. PE: WNL, abdomen soft and nontender. Surgery reduction ileocecal intussusception and appendectomy


VAERS ID: 274365 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-03-19
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Barium enema, Intussusception, X-ray
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: barium enema X-ray
CDC Split Type: WAES0703USA01323

Write-up: Information has been received from a retired physician concerning his granddaughter who was vaccinated with a 2 ml oral dose of Rotateq. Subsequently the patient was treated for intussusception. It was reported that a barium enema was performed. At the time of the report the patient was recovering. No product quality complaint was involved. No other information was provided. Upon internal review, the patient''s intussusception was considered to be an other important medical event. Additional information is not expected.


VAERS ID: 274366 (history)  
Form: Version 1.0  
Age: 0.42  
Gender: Female  
Location: New York  
Vaccinated:2007-01-17
Onset:2007-03-07
   Days after vaccination:49
Submitted: 2007-03-19
   Days after onset:11
Entered: 2007-03-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK UN / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR 1110F / UNK UN / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 2 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Barium double contrast, Constipation, Diarrhoea, Gastroenteritis rotavirus, Haematochezia, Intussusception, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK records received 4/12/07-Labs SEgs 80.7. lymphs 15.6. Blood culture no growth. Abdominal x-ray highly suspicious for intussusception
CDC Split Type: WAES0703USA01485

Write-up: Information has been received from a health professional concerning a 6 month old female, with no medical history and no allergies, who was vaccinated with a first and second 2 ml oral dose of Rotateq on 19-OCT-2006 and 17-JAN-2007 (Lot# 655866/1110F), respectively. Concomitant vaccinee administered on 17-JAN-2007 included a dose of diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid, a dose of IPOL, a dose of PedvaxHIB (manufacturer unknown) and a dose of Prevnar. It was reported that, according to the hospital discharge summary, 24 hours prior to presentation at the hospital, on 07-MAR-2007, the patient began with nausea, vomiting, abdominal pain and constipation. The patient was admitted to the hospital on 08-MAR-2007 and had episodes of vomiting, diarrhea, and bloody stools. The patient was diagnosed with ileocolic intussusception, which was initially encountered in the distal transverse colon. It was also noted by the physician on the discharge summary that the patient had rotavirus. The patient did not have surgery and the intussusception was reduced by an air contrast enema. The patient was discharged on 10-MAR-2007 and had recovered. The patient''s intussusception and rotavirus were considered to be other important medical events by the reporter. A lot check has been requested. Additional information has been requested. 04/12/07-records received from facility for DOS 03/08-03/10/2007. DC DX: Ileocolic intussusception. Diagnosed and treated with air contrast enema. Developed abdominal pain 24 hours prior to presentation with decreased PO intake, several episode of vomiting and an episode of diarrhea but no further bowel movements over 24 hours. Febrile to 38.3. PE bowel sounds present soft non distended tender to palpation no masses palpable. Rectal grossly bloody stool in rectal vault.


VAERS ID: 274395 (history)  
Form: Version 1.0  
Age: 0.17  
Gender: Female  
Location: California  
Vaccinated:2007-01-17
Onset:2007-03-15
   Days after vaccination:57
Submitted: 2007-03-20
   Days after onset:5
Entered: 2007-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B079BA / 1 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0784F / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 836258A / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0779F / 1 MO / PO

Administered by: Other       Purchased by: Unknown
Symptoms: Barium double contrast, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: records received 3/28/07-Intussusception. Confirmed by ultrasound and successfully reduced with air contrast barium enema
CDC Split Type:

Write-up: Patient developed intussusception 3/15/07 sent to hospital - reduced with barium air enema. 03/28/07-DC summary received. DC DX: Intussusception. Confirmed by ultrasound and successfully reduced with air contrast barium enema.


VAERS ID: 274556 (history)  
Form: Version 1.0  
Age: 0.35  
Gender: Male  
Location: Missouri  
Vaccinated:2006-11-06
Onset:2006-12-09
   Days after vaccination:33
Submitted: 2007-03-22
   Days after onset:102
Entered: 2007-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS ? / 2 UN / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. ? / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Bowel movement irregularity, Cold sweat, Crying, Decreased appetite, Foaming at mouth, Haematochezia, Hypotonia, Insomnia, Intussusception, Irritability, Pain, Screaming, Shock, Stomach discomfort, Thrombosis, Ultrasound abdomen, Vomiting, Wheezing, X-ray
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Convulsions (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Thrombophlebitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zantac
Current Illness:
Preexisting Conditions: Reflux PMH: GERD, bilat ing hernia repair, chickenpox, Birth HX: full term, unremarkable
Allergies:
Diagnostic Lab Data: LABS: air contrast enema revealed & successfully treated IS. No x-ray reports included w/records.
CDC Split Type:

Write-up: Our son has been having severe bowel cramping ever since the first dose of the rotavirus vaccine RotaTeq. He has suffered from abdominal cramping, severe crying spells, problems passing bowel movements, decreased appetite, fussiness, and loss of sleep. After having the second dose of the vaccine, his symptoms worsened until he finally developed intussuception. The day he developed this adverse reaction he began the morning with his usual fussiness. He hadn''t slept well the night before and was having trouble being held and bending in the middle. As I tried to give him his morning feeding, he persistantly refused to nurse and became more and more fussy. He arched his back and his stomach became hard. He began screaming out in pain and essentially foaming at the mouth. Following a severe screaming and crying spell, he went into shock. His skin became cool and clammy and he went limp in my arms. We called the pediatrician and they told us to take a rectal temperature. While taking a rectal tempature he passed a large bowel movement containing jelly-like blood clots. We rushed him to the emeregency room where he began to wheeze and vomit up bile. They took an X-ray of his abdomin, and followed up the X-ray with an ultrasound. The ultrasound confirmed the bowel telescoping. They did an air contrast enema to reduce the obstruction and then kept him in the hospital for the next two days for monitoring. When we met with our pediatrician following the intussuception, he didn''t mention that it could be related to the rotavirus vaccine. He went ahead and administered the third dose of the vaccine about a month after our son''s hospitalization. Since the third dose of the vaccine, we have been back to the emergency room with the same symptoms, but the bowel twisting has resolved itself without further medical enemas. 3/23/07 Received ER medical records which reveal patient experienced nasal congestion, pulling at left ear & irritability for approx 3 days prior to being seen in ER on 3/18/07. Exam revealed reddened left TM. PMH: s/p IS 3 wks ago. FINAL DX: left otitis media. 4/13/07 Received medical records from treating hospital which reveals patient experienced jaw clenching, diaphoresis, screaming, pallor, gen fussiness & bloody stools. In ER had bilious vomiting. Held overnight s/p IS reduction by enema. Progressed well & d/c to home. FINAL DX: Intussusception, reduced by air contrast enema.


VAERS ID: 274607 (history)  
Form: Version 1.0  
Age: 0.18  
Gender: Female  
Location: Unknown  
Vaccinated:2007-02-06
Onset:2007-03-10
   Days after vaccination:32
Submitted: 2007-03-22
   Days after onset:11
Entered: 2007-03-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2552AA / 1 - / -
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBV319AA / 2 - / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE990AA / 1 - / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0306 / 1 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08646D / 1 - / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1116F / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK Birth Hx: normal FT birth & pregnancy per ER record.
Allergies:
Diagnostic Lab Data: Labs in ER: WBC 12, Hgb 12, segs 67, lymphs 25 LABS: On admit to 2nd hospital: WBC 12.2, Hgb 12.2, plts 459. Abdominal x-ray c/w SBO. US of abdomen revealed +IS. Air contrast enema x 2 failed to reduce. Post op WBC 17.7, Hgb 10.3
CDC Split Type: WAES0703USA03407

Write-up: Information has been received from a physician concerning a 3 month old patient who was vaccinated with the first dose of Rotateq. Subsequently, the patient experienced intussusception and was hospitalized. Intussusception was considered to be immediately life-threatening and an other important medical event. The outcome was not reported. Additional information has been requested. 4/6/07 Received medical records from both hospitals today which reveal: Hospital #1 ER - seen 3/10/07 for blood in stool night before & that AM. Also vomited that AM. Was seen by PCP on 3/9 & thought to be possible allergy, tx w/benadryl. After second bloody stool, went to ER. Dx w/acute GI bleed. Tx w/IVF & transferred to higher level of care. Hospital #2 Admission 3/10/07-3/13/07. Received into PICU & surg consult obtained. Exam revealed patient to be lethargic & mildly dehydrated despite prior IVFs. Abdomen was soft, nondistended w/+BS but also with a palpable mass along the left side of the abdomen, LLQ. Rectal exam revealed mucosal mass almost protruding from rectum. Air contrast enema x2 failed to reduce. Patient taken to OR for exp lap, reduction of right colon-ileocecal IS w/difficulty due to edematous & ischemic cecum & appendectomy. Patient progressed well & was able to tolerate oral diet prior to d/c on 3/13/07. FINAL DX: Ileocecal intussusception, surgically reduced.


VAERS ID: 274629 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Male  
Location: D.C.  
Vaccinated:2007-03-20
Onset:2007-03-22
   Days after vaccination:2
Submitted: 2007-03-23
   Days after onset:1
Entered: 2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B070BA / 1 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08655E / 1 RA / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0779F / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal X-ray, Intestinal perforation, Intussusception
SMQs:, Gastrointestinal obstruction (narrow), Gastrointestinal perforation (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LASIX, DIGOXIN, ZANTAC, ASA
Current Illness: HYPOPLASTIC RIGHT HEART, D-TGA, TRICUSPIC VALVE STENOSIS, SUB-AORTIC STENOSIS, VSD, HYPOPLASTIC AORTIC ARCH, AORTA COARCTATION, S/P NORWOOD I & BT SHUNT, FEEDING INTOLERANCE, S/P RECENT GASTRENTERITIS (ROTAZYME(-), STOOL Cx(-).
Preexisting Conditions: PER 18 PMH: hypoplastic right ventricle, D-TGA, s/p Norwood w/BT shunt
Allergies:
Diagnostic Lab Data: ABD XR LABS: abdominal x-ray abnormal; US of abd c/w LLQ intussusception. Contrast enema given & patient had transverse colon bowel perforation. WBC increased
CDC Split Type:

Write-up: INTUSSUSCEPTION, BOWEL PERFPRATION 5/25/07 Received hospital medical records which reveal patient experienced bloody stools x 4 days prior to admit 3/22/07-4/6/07. Patient to OR after bowel perforation for exp lap & colostomy was done. ID consult done & started on multiple IV antibiotics. Initially vented but able to extubate quickly. To cath lab on 3/29 for dilation of coarctation. Transfused for low H/H. Tolerated oral feedings as well as NGT feedings. GI consult revealed GERD & delayed gastric emptying. Progressed well & was d/c to home w/close f/u by multiple specialties. FINAL DX: Intussception; bowel perforation secondary to BE; exp lap & colostomy.


VAERS ID: 274768 (history)  
Form: Version 1.0  
Age: 0.65  
Gender: Male  
Location: Indiana  
Vaccinated:2007-03-02
Onset:2007-03-05
   Days after vaccination:3
Submitted: 2007-03-13
   Days after onset:7
Entered: 2007-03-26
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B092AA / 3 LL / -
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF077AA / 3 RL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 3 RL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1109F / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Barium enema, Intussusception, Surgery
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Barium enema (+) for partially resolving ileocolic intussusception. Abdominal Survey:no free air is demonstrated. No gas can be seen on right side of abdomen. Findings may be due to mild constipation. Concern for intusssusception. Barium enema. ileocolic intussusception that reduced easily from distal transverse colon to ileoceal valve but was unable to completely reduce the intussusception despite several attempts.
CDC Split Type:

Write-up: Child developed an ileocolic intussusception 3/5/07. To surgery on 3/6/07. 04/03/07-records received from facility DC DX: Intussusception. Colicky abdominal pain. No bloody stool. Acute bilious vomiting. Surgical procedure:laparotomy, reduction of intussusception, appendectomy. Post operative diagnosis:ileocolic intussusception.


VAERS ID: 274772 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Male  
Location: Louisiana  
Vaccinated:2007-01-09
Onset:2007-03-12
   Days after vaccination:62
Submitted: 2007-03-26
   Days after onset:14
Entered: 2007-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21BC03AA / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1159R / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08657F / 2 LL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0695F / 2 MO / PO

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain, Intussusception, Surgery
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK records received 4/24/07-Gastrografin enema water soluble attempt unsuccessful.
CDC Split Type:

Write-up: Unsure - dad reported patient brought to ER for abdominal pain and was diagnosed with intussusception and had it surgically repaired at facility reported. Patient never seen here for that04/24/07-records received from facility for DOS 03/14-03/15/07. DC DX: Intussusception Ileocolic. HX of emesis and bloody stools. Gastrografin enema water soluble attempt unsuccessful. Exploratory laparotomy with manual reduction of intussusception. Incidental appendectomy. problem.


VAERS ID: 274817 (history)  
Form: Version 1.0  
Age: 0.34  
Gender: Male  
Location: Missouri  
Vaccinated:2007-02-05
Onset:2007-03-18
   Days after vaccination:41
Submitted: 2007-03-26
   Days after onset:8
Entered: 2007-03-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B074AA / 2 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0407F / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B086840 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1114F / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Diarrhoea haemorrhagic, Intussusception, Ultrasound abdomen, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: air contrast enema, abd ultrasound US:Instussusception identified in left upper quadrant of abdomen. Reduction with therapeutic enema. Recurrance seen on US in small ileocolic intussusception at level of cecum. Second therapeutic enema. Presented with abdominal pain positive bloody stools, nonbilious emesis. Labs: WNL.
CDC Split Type:

Write-up: 3/18/07 went to Hospital ER for vomiting and bloody diarrhea. Diagnosed with intussusception. Treated with reduction twice. Hospitalized 3/18-3/20/07. 04/02/07-ER and Diagnostic records received from facility. US:Instussusception identified in left upper quadrant of abdomen. Reduction with therapeutic enema. Recurrance seen on US in small ileocolic intussusception at level of cecum. Second therapeutic enema. Presented with abdominal pain positive bloody stools, nonbilious emesis. Labs: WNL.


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