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This is VAERS ID 272462

(NOTE: This result is from the 8/31/2010 version of the VAERS database)

Case Details

VAERS ID: 272462 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: Maryland  
Vaccinated:2007-01-24
Onset:2007-02-17
   Days after vaccination:24
Submitted: 2007-02-17
   Days after onset:0
Entered: 2007-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 - / -
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 1 - / -
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0940F / 1 - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Barium double contrast, Enteroenterostomy, Haematochezia, Intussusception, Surgery, Ultrasound abdomen abnormal, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

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, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: Air contrast enema x 2
CDC Split Type:

Write-up: intussussception 3/20/07 Received medical records from hospital which reveal patient experienced vomiting & bloody stools for 1 day. Seen at outlying ER on 2/16 & tx w/air contrast enema for +IS then transferred for higher level of care. Admitted to hospital 2/17-2/24/07. Air contrast enema from outlying ER successful but f/u US of abdomen revealed IS had recurred. Repeat air contrast enema reduced IS but again recurred & was so was taken to OR. Stayed in PICU for several days observation & treated w/antibiotics & TPN. Transitioned to oral feeds & antibiotics d/c 2 days prior to d/c home w/o further complication. FINAL DX: Intussusception, RLQ in cecum, adjacent to eleocecal valve. Surgically reduced after failure of air contrast enemas x 2. Exp lap; segmental resection of IS, ileal; & enteroenterostomy.


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