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This is VAERS ID 273446

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 273446 (history)  
Form: Version 1.0  
Age: 0.52  
Gender: Female  
Location: Michigan  
Vaccinated:2007-01-15
Onset:2007-02-26
   Days after vaccination:42
Submitted: 2007-03-05
   Days after onset:7
Entered: 2007-03-06
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC218092AA / 3 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1015F / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08672K / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0139F / UNK MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal X-ray, Abdominal pain, Constipation, Intussusception, Surgery, Ultrasound abdomen, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Abd X ray and US of abd. Labs and Diagnostics: Abdominal/Pelvic x-ray showed a suggestion of hepatomegaly with displacement of bowel loops into the left abdomen. Abdominal US show (+) presence of extensive intussusception in the transverse colon. Barium enema showed (+) intussusception within the transverse colon. Chemistry showed Na+ of 138 and 134. UA (+) for 2+ Ketones. CBC unremarkable. Viral cultures (-). Hepatic panel showed low Tot. prot., Albumin, Globulin.
CDC Split Type:

Write-up: Vomiting, constipated, abdominal pain. Treatment - surgery for intussusception. 04/16/2007 MR received for 2 night hospitalization 3/3-5/2007 for a 6 day h/o crampy abdominal pain, lack of bowel movement, and vomiting. Partial reduction of the intussusception was completed, however focal intussusception remained in the distal terminal ileum which was surgically reduced via open reduction. Discharge DX: Intussusception.


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