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This is VAERS ID 352902

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 352902
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / - - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upp
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. DC DX Intussusception. ICD-9 code 560.0


Changed on 4/7/2010

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR 3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / - 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upp
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. DC DX Intussusception. ICD-9 code 560.0


Changed on 5/11/2010

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR 3242AA C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Urinary system X-ray, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upp
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. DC DX Intussusception. . ICD-9 code 560.0


Changed on 8/31/2010

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Urinary system X-ray, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upp
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 1/4/2011

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Urinary system X-ray, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upp upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 4/13/2011

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 5/13/2011

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 6/11/2011

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 5/13/2013

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 RL / IM
ROTH1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 2/14/2017

VAERS ID: 352902 Before After
VAERS Form:
Age:0.4 0.39
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 4/14/2017

VAERS ID: 352902 Before After
VAERS Form:
Age:0.39
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Irritability, Urinary system X-ray, Vomiting, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 9/14/2017

VAERS ID: 352902 Before After
VAERS Form:(blank) 1
Age:0.39
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 0 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 1 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 0 1 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Urinary system X-ray, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 2/14/2018

VAERS ID: 352902 Before After
VAERS Form:1
Age:0.39
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Urinary system X-ray, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0


Changed on 6/14/2018

VAERS ID: 352902 Before After
VAERS Form:1
Age:0.39
Gender:Male
Location:New York
Vaccinated:2009-07-24
Onset:2009-07-30
Submitted:2009-07-31
Entered:2009-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3242AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D48927 / 2 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FA802A / 1 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intussusception, Urinary system X-ray, Enema administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: None Allergies: NKDA
Allergies:
Diagnostic Lab Data: KUB: findings which suggest an intussusception with the leading edge in the left transverse colon. The air in the right and transverse colon appears to have been displaced and there is what appears to be dilated small bowel in the right upper right quadrant of the abdomen. Air enema: ileo-colo-colic intussusception with satisfactory reduction. Labs none noted Dx studies: Xrays of abdomen + for intussusception, barium enem
CDC 'Split Type':

Write-up: intussusception 11/18/2009 ED record for 7/30-7/31/2009. DC DX Intussusception Patient with c/o''s irritability, vomiting. Xrays + for intussusception which was reduced per air enema. F/up xrays noted resolution. . ICD-9 code 560.0

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