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This is VAERS ID 291861

Case Details

VAERS ID: 291861 (history)  
Form: Version 1.0  
Age: 0.39  
Gender: Male  
Location: Tennessee  
Vaccinated:2007-09-17
Onset:2007-09-30
   Days after vaccination:13
Submitted: 2007-10-02
   Days after onset:2
Entered: 2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0876U / 2 UN / UN

Administered by: Public       Purchased by: Public
Symptoms: Computerised tomogram, Enema administration, Intussusception, Urinary system X-ray
SMQs:, Gastrointestinal obstruction (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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: KUB, CT abdomen, Air enema 10/15/07-records received-10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. KUB, CT scan, air enema
CDC Split Type:

Write-up: Intussusception 10/15/07-records received for DOS 10/1/07-DX Intussusception. Presented to ED with vomiting and bloody stools last 2 days. Onset abrupt. Exploratory laparotomy with reduction of intussusception and incidental appendectomy. Therapeutic enema with air contrast unsuccessful in reduction of intussusception beyond the level of ileocecal. Follow-up Information 02-OCT-2007: Intussusception treated with surgery


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