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From the 12/8/2009 release of VAERS data (an older release, current is 1/7/2021):

This is VAERS ID 336186

Case Details

VAERS ID: 336186 (history)  
Form: Version .0  
Age: 0.3  
Sex: Female  
Location: Foreign  
   Days after vaccination:54
Submitted: 2008-12-29
   Days after onset:232
Entered: 2008-12-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal X-ray, Abdominal distension, Appendicectomy, Dehydration, Gastrointestinal hypomotility, Haematochezia, Hyperaemia, Hypophagia, Intestinal obstruction, Intussusception, Pyrexia, Vomiting, X-ray abnormal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Abdominal X-ray, May 2008, see text
CDC Split Type: B0551530A

Write-up: This case was reported by a physician in the frame of a study and described the occurrence of ileocecal intussusception in a 6-month-old female subject who was vaccinated with ROTARIX (GlaxoSmithKline). The subject was on no other medication and had no relevant medical history or allergy. On 18 March 2008, the subject received 1st dose of ROTARIX (oral). Lot number not provided. On 11 May 2008, 54 days after vaccination with ROTARIX, the subject started with vomiting. The patient was admitted at ER on 11 May 2008 and showed at physical exam dehydration, hyperemic pharynx, abdominal distension, oral intake reduced. On 12 May 2008, the subject experienced bloody stools, fever, biliary vomiting and decreased gastrointestinal peristalsis. Abdominal x-ray showed distended small bowel, air-fluid levels and intestinal obstruction. Surgery was done on 13 May July 2008. Ileocecal intussusception in ileocecal valve was found, reduced by taxis with appendectomy without complications. The subject was treated with DIPHENIDOL, PARACETAMOL and TRIMETHOPRIM. On 19 May 2008, the events were resolved. The subject was discharged in good clinical conditions. The physician considered the events were unrelated to vaccination with ROTARIX. No additional information requested therefore the case has been closed.

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