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This is VAERS ID 273495

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273495
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated saus"age like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending


Changed on 12/8/2009

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated saus"age sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 1/5/2010

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / AVENTIS PASTEUR SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / LEDERLE LABORATORIES WYETH PHARMACEUTICALS, INC B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 3/2/2010

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 4/7/2010

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 8/31/2010

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Barium swallow abnormal, Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 1/4/2011

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Barium swallow abnormal, Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 4/13/2011

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 5/13/2011

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 6/11/2011

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 5/13/2013

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 6/14/2014

273495 Before After
VAERS Form:
Age:0.3
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 2/14/2017

273495 Before After
VAERS Form:
Age:0.3 0.33
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 5/14/2017

273495 Before After
VAERS Form:
Age:0.33
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal mass, Abdominal tenderness, Barium swallow abnormal, Faeces discoloured, Intussusception, Laparotomy

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


Changed on 9/14/2017

273495 Before After
VAERS Form:(blank) 1
Age:0.33
Gender:Female
Location:Georgia
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-06
Entered:2007-03-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 1 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF009AB / 1 2 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0547 / 1 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B36258C / 1 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 1 2 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omnicef 125mg/5ml 3ml po QD X 10DI
Current Illness: Improved AOM
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Labs: WBC 22,000. All other labs WNL
CDC 'Split Type':

Write-up:Intussusception 03/08/07-records received from facility for DOS 03/03-03/05/07 DC DX: Intussusception Increased fussiness times one day, the day prior to admission became more fussy, noticed currant jelly stools times three. Presented to PCP palpated sausage like mass in right upper quadrant as well as currant jelly stools. PE: Abdomen positive tenderness to palpation, no masses at that time. Positive for currant jelly stool in diaper. Air contrast enema showed intussusception all way down the descending colon. Reduced by enema. However, no air could be pushed the the ileocecal valve, surgery laparoscopic converted to open reduction of intussusception. Small bowel intussusception into the colon, the appendix was sucked into the intussusception, the intussusceiption went to the beginning of the transverse colon.


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