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This is VAERS ID 339776

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 339776 (history)  
Form: Version 1.0  
Age: 0.34  
Sex: Male  
Location: Tennessee  
Vaccinated:2009-01-05
Onset:2009-01-08
   Days after vaccination:3
Submitted: 2009-01-12
   Days after onset:4
Entered: 2009-02-18
   Days after submission:37
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3227AA / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D16284 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1356X / 2 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Colectomy, Intussusception, Ultrasound abdomen, Urinary system X-ray
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal obstruction (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: None
Current Illness: None
Preexisting Conditions: None 2/24/09-meconium aspiration.
Allergies:
Diagnostic Lab Data: KUB/Abdominal ultrasound 2/24/09-records received-pneumatic enema reduction unsuccessful. Head CT normal. Chest x-ray showed small area of atelectasis.
CDC Split Type:

Write-up: Intussusception. Required partial colectomy. 2/24/09-records received for DOS 1/8-1/13/09-DC DX: Intussusception. Presented with 2 day history of lethargy and vomiting, increased fussiness increased reflux. Attempted pneumatic reduction of intussusception unsuccessful. Partial reduction by laparoscopy and partial colectomy with removal of terminal ileum and ileocolostomy. Intussusception irreducile and resection of terminal ileum and right colon.


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