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This is VAERS ID 382394

Case Details

VAERS ID: 382394 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2009-06-06
Submitted: 2010-03-11
   Days after onset:278
Entered: 2010-03-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Dehydration, Diarrhoea, Haematochezia, Intussusception, Irritability, Laparotomy, Rhinorrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad), Dehydration (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:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: B0638853A

Write-up: This case was reported by a physician and described the occurrence of invagination of intestine in a 4-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject did not have relevant medical history. On an unspecified date, the subject received unspecified dose of ROTARIX (1 ml, oral). On 6 June 2009, at an unspecified time after vaccination with ROTARIX, the subject experienced watery thinorrhea, gastric/biliary vomiting, irritability, abdominal pain and blood stools. On 9 June 2009, the subject was admitted. The subject presented dehydration, no peristalsis and positive "morcilla" sign and suspicious probably ileocecocolic intestinal intussusception which was confirmed the same day. The subject was hospitalised and the physician considered the events were clinically significant (or requiring intervention). A plain abdominal radiograph was not performed. An abdominal ultrasound was not performed. An abdominal CT was not performed. The subject was treated with laparotomy and taxis on 9 June 2009 without complications and without bowel resection. After good medical conditions, the subject was discharged on 14 June 2009. On 14 June 2009, the events were resolved.


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