VAERS ID: |
283993 (history) |
Form: |
Version .0 |
Age: |
0.5 |
Gender: |
Female |
Location: |
Wisconsin |
Vaccinated: | 2007-06-06 |
Onset: | 2007-06-30 |
Days after vaccination: | 24 |
Submitted: |
2007-07-02 |
Days after onset: | 2 |
Entered: |
2007-07-06 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS |
AC21B101AA / 2 |
LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH |
B08674A / 2 |
RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. |
0236U / 2 |
- / PO |
Administered by: Private Purchased by: Public Symptoms: Abdominal X-ray,
Barium enema,
Computerised tomogram,
Full blood count,
Intussusception,
Laboratory test,
Surgery,
Ultrasound scan,
Urine analysis 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, 3 days
Extended hospital stay? No
Previous Vaccinations: Other Medications: None Current Illness: Preexisting Conditions: PMH: none noted. NKDA. Allergies: Diagnostic Lab Data: Abdominal X-ray, U/S, CT, barium enema, CBC, UA, Chem labs. Labs and Diagnostics: CBC normal, electrolytes normal, CXR and KUB normal. Abd ultrasound with abnormal segment of bowel in the RUQ with thickening (bowel in bowel?) Suggests upper GI or Barium enema. Labs and Diagnostics: CT scan of abdomen (+) for intussusception. Abdominal X-ray with dilated bowel loops. Barium enema performed with IS identified but reduction was not possible x 3 attempts. CDC Split Type:
Write-up: Intussusception 6/30 Surgical correction 7/1. Infant presented to ER with multiple episodes of vomiting, no diarrhea. Child transfered to admitting hospital. 07/30/2007 MR received from admitting hospital for DOS 7/1-4/2007. She was transferred via helicopter for eval and tx for an irreducible Intussusception. Child had an exploratory lap with reduction of ileocolic intussusception. Intussuscepted bowel was 2'' to a Meckel diverticulum. Resection of Meckel Diverticulum and ileum also done. Discharge DX: Intussusception. Meckel Diverticulum. |