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This is VAERS ID 341630

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 341630
VAERS Form:
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D26083 / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Appendicectomy, Barium enema abnormal, Cough, Diarrhoea, Enterocolitis, Inguinal hernia repair, Intussusception, Irritability, Laparoscopy abnormal, Lymphadenopathy, Surgery, Enema administration, Ultrasound abdomen abnormal, Explorative laparotomy, Gastrointestinal oedema, Occult blood negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 3/2/2010

VAERS ID: 341630 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC D26083 / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Appendicectomy, Barium enema abnormal, Cough, Diarrhoea, Enterocolitis, Inguinal hernia repair, Intussusception, Irritability, Laparoscopy abnormal, Lymphadenopathy, Surgery, Enema administration, Ultrasound abdomen abnormal, Explorative laparotomy, Gastrointestinal oedema, Occult blood negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 4/7/2010

VAERS ID: 341630 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 1 RL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D26083 / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Appendicectomy, Barium enema abnormal, Cough, Diarrhoea, Enterocolitis, Inguinal hernia repair, Intussusception, Irritability, Laparoscopy abnormal, Lymphadenopathy, Surgery, Enema administration, Ultrasound abdomen abnormal, Explorative laparotomy, Gastrointestinal oedema, Occult blood negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 8/31/2010

VAERS ID: 341630 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH D26083 / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Appendicectomy, Barium enema abnormal, Cough, Diarrhoea, Enterocolitis, Inguinal hernia repair, Intussusception, Irritability, Laparoscopy abnormal, Lymphadenopathy, Surgery, Enema administration, Ultrasound abdomen abnormal, Explorative laparotomy, Gastrointestinal oedema, Occult blood negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 5/13/2013

VAERS ID: 341630 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 1 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Appendicectomy, Barium enema abnormal, Cough, Diarrhoea, Enterocolitis, Inguinal hernia repair, Intussusception, Irritability, Laparoscopy abnormal, Lymphadenopathy, Surgery, Enema administration, Ultrasound abdomen abnormal, Explorative laparotomy, Gastrointestinal oedema, Occult blood negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 4/14/2017

VAERS ID: 341630 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Appendicectomy, Barium enema abnormal, Cough, Diarrhoea, Enterocolitis, Inguinal hernia repair, Intussusception, Irritability, Laparoscopy abnormal, Lymphadenopathy, Surgery, Enema administration, Ultrasound abdomen abnormal, Explorative laparotomy, Gastrointestinal oedema, Occult blood negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 9/14/2017

VAERS ID: 341630 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 1 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 1 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 1 2 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 2/14/2018

VAERS ID: 341630 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 6/14/2018

VAERS ID: 341630 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 8/14/2018

VAERS ID: 341630 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 9/14/2018

VAERS ID: 341630 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.


Changed on 10/14/2018

VAERS ID: 341630 Before After
VAERS Form:1
Age:0.3
Sex:Female
Location:Arizona
Vaccinated:2009-03-02
Onset:2009-03-10
Submitted:2009-03-12
Entered:2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3226AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D26083 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1585X / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Surgery

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 6     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild diarrhea for 2 days
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: LABS: US abdomen x 2 (+) IS. Stool OB (-). BE unsuccessful.
CDC 'Split Type':

Write-up: Diagnosed with intussusception 8 days after 4 month vaccines. Neede surgery and was discharged 2 days later, 3/16/09 Received hospital medical records for 3/10-3/11/2009 & 3/12-3/15/2009. FINAL DX: Enterocololitis, probable intussusception, exp laparotomy, appendectomy, right inguinal hernia repair Records reveal patient experienced irritability, diarrhea x approx 7-10 days, intermittent abdominal cramping & nonbloody stool x1on 3/10. Multiple attempts to reduce w/BE unsuccessful. Taken to OR where no obvious IS seen. Progressed well post op & d/c to home. Developed recurrent bouts of abdominal pain & cough at home. Taken back to OR for diagnostic laparoscopy where no IS seen but colon dilated, prominent adenopathy & thickened ascending colon. Referred to GI.

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