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Administered by: Unknown Purchased by: Unknown
Life Threatening? Yes
Write-up: Patient developed GI symptoms (vomiting) on 2/3/2007 (31 days after receiving 3rd Rotateq). Was diagnosed with intussception on 2/7/2007. Suffered perforation of intestine during attempt to reduce by Barium enema, requiring emergent laparotomy and reanastomosis of small bowel. Suffered a 2nd bowel perforation on 2/12/2007. Illness resulted in ICU admission, intubation, probable sepsis. 3/15/07 Received partial medical records from hospital which reveal patient admitted 2/7/07 after experienced +IS s/p perforation x 2 w/OR repair who developed fever, elevated WBC, increasing discomfort & irritability. Returned to OR on 2/15 for transverse colon perforation. FINAL DX: none at present as patient still hospitalized. Peritonitis, either resistant bacteria such as MRSA or fungal were considered likely. T/C to hospital to determine D/C status of patient & to request D/C Summary if available. Patient d/c to home 3/14. No D/C Summary dictated yet. Will request later. 4/10/07 Received D/C summary from hospital which reveals patient admitted from 2/7/07-3/14/07. Admitted w/abdominal pain & emesis x approx 5 days w/lethargy & dehydration. Treated at outlying hospital w/IVF prior to transfer for surgery on 2/7/07 was exp lap w/ileocecectomy w/primary anastomosis; then, lysis of adhesions & repair of transverse colon perforation on 2/12/07. Condition was critical & worsened prior to second surgry w/patient remaining intubated & in PICU. After second surgery & continued IVF, antibiotics & TPN, had gradual improvement & was successfully extubated. Despite treatment, continued to have intermittent fevers & multiple w/ups were done, all were neg for source of infection. Transitioned from TPN to NJ feeds & was transferred to regular peds floor. Gradually, oral feeds were introduced & tolerated & NJ feeds were d/c. Patient had become accustomed to MSO4 pain med & had extensive wean w/ativan & methadone. Bowel function had returned to normal by d/c to home w/f/u w/PCP & surgery. FINAL DX: Intussusception complicated by small bowel perforation & transverse colon perforation. Per information received from the annual follow up patient did have the complication of intestinal perforation twice after diagnosis of intussusception, was hospitalized for greater than 1 month.
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