National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 331912

(NOTE: This result is from the 5/13/2013 version of the VAERS database)

Case Details

VAERS ID: 331912 (history)  
Form: Version .0  
Age: 0.5  
Gender: Female  
Location: Oregon  
Vaccinated:2008-10-30
Onset:2008-11-05
   Days after vaccination:6
Submitted: 2008-11-10
   Days after onset:5
Entered: 2008-11-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B192CA / 2 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF505AB / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH UNKNOWN / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA692A / 0 - / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal X-ray, Barium double contrast, Barium enema abnormal, Enema administration, Haematochezia, Haematocrit decreased, Haemoglobin decreased, Intussusception, Laparoscopy, Large intestinal obstruction reduction, Moaning, Pain, Platelet count increased, Surgery, Urinary system X-ray, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

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, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none. PMH: none
Allergies:
Diagnostic Lab Data: KUB/contrast enemas. Labs and Diagnostics: Air contrast enema (+) for IS. Abd X-ray c/w IS. HCT 31.5. Hgb 10.4. Platelets 15.2K.
CDC Split Type:

Write-up: Intussusception - symptoms started 11/5/08; confirmed by x-ray on 11/6/08; unable to reduce by air contrast and barium contrast; required air transport to tertiary hospital and subsequent surgery. 11/18/2008 D/C Summary recieved for DOS 11/17-19/2008 with Final DX: Intussusception-ileocolic. Pt initially presented with pain, moaning, vomiting and blood streaked stool. Pt presented to hospital from another facility following failed reduction of IS via air contrast barium enema. Again, uanable to reduce so taken to OR for Laparoscopic reduction. Pt tolerated well, diet advance and d/c 11/9/08.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20130513&IDNUMBER=331912


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166