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This is VAERS ID 316224

Case Details

VAERS ID: 316224 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Iowa  
Vaccinated:2008-03-14
Onset:2008-05-22
   Days after vaccination:69
Submitted: 2008-06-13
   Days after onset:22
Entered: 2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Intestinal obstruction, Intussusception, Surgery
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC Split Type:

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


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