National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 903931

History of Changes from the VAERS Wayback Machine

First Appeared on 12/24/2020

VAERS ID: 903931
VAERS Form:2
Age:29.0
Sex:Male
Location:Washington
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Military      Purchased by: ??
Symptoms: Abdominal pain, Blood creatinine normal, C-reactive protein increased, Computerised tomogram abnormal, Dehydration, Haematocrit increased, Small intestinal obstruction, Computerised tomogram abdomen, Scan with contrast abnormal, Gastrointestinal inflammation, Gastrointestinal wall thickening

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Denies any home medications
Current Illness: None
Preexisting Conditions: None
Allergies: Denies any allergies
Diagnostic Lab Data: 12/18/20 - CT Abdomen and Pelvis w/ Contrast
CDC 'Split Type':

Write-up: Presented with periumbilical pain to emergency department (patient works at Medical Center). Admitted to hospital for small bowel obstruction. Labs were consistent with dehydration (Hct 55, Cr 1.25), as well as CRP 1.10. A CT Abd/Pelvis identified proximal dilation and fecalization of small bowel, with a transition point in the left lower quadrant. Distal to the transition point, the small bowel appears thick, with hyperenhancement and inflammation progressing into the cecum. General Surgery was consulted and patient admitted to hospital for management of this small bowel obstruction.


Changed on 12/30/2020

VAERS ID: 903931 Before After
VAERS Form:2
Age:29.0
Sex:Male
Location:Washington
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Military      Purchased by: ??
Symptoms: Abdominal pain, Blood creatinine increased, Blood creatinine normal, C-reactive protein increased, Computerised tomogram abnormal, Dehydration, Haematocrit increased, Small intestinal obstruction, Computerised tomogram abdomen, Scan with contrast abnormal, Gastrointestinal inflammation, Gastrointestinal wall thickening

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Denies any home medications
Current Illness: None
Preexisting Conditions: None
Allergies: Denies any allergies allergies
Diagnostic Lab Data: 12/18/20 - CT Abdomen and Pelvis w/ Contrast
CDC 'Split Type':

Write-up: Presented with periumbilical pain to emergency department (patient works at Medical Center). Admitted to hospital for small bowel obstruction. Labs were consistent with dehydration (Hct 55, Cr 1.25), as well as CRP 1.10. A CT Abd/Pelvis identified proximal dilation and fecalization of small bowel, with a transition point in the left lower quadrant. Distal to the transition point, the small bowel appears thick, with hyperenhancement and inflammation progressing into the cecum. General Surgery was consulted and patient admitted to hospital for management of this small bowel obstruction.


Changed on 5/7/2021

VAERS ID: 903931 Before After
VAERS Form:2
Age:29.0
Sex:Male
Location:Washington
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Military      Purchased by: ??
Symptoms: Abdominal pain, Blood creatinine increased, C-reactive protein increased, Computerised tomogram abnormal, Dehydration, Haematocrit increased, Small intestinal obstruction, Computerised tomogram abdomen, Scan with contrast abnormal, Gastrointestinal inflammation, Gastrointestinal wall thickening

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Denies any home medications
Current Illness: None
Preexisting Conditions: None
Allergies: Denies any allergies allergies
Diagnostic Lab Data: 12/18/20 - CT Abdomen and Pelvis w/ Contrast
CDC 'Split Type':

Write-up: Presented with periumbilical pain to emergency department (patient works at Medical Center). Admitted to hospital for small bowel obstruction. Labs were consistent with dehydration (Hct 55, Cr 1.25), as well as CRP 1.10. A CT Abd/Pelvis identified proximal dilation and fecalization of small bowel, with a transition point in the left lower quadrant. Distal to the transition point, the small bowel appears thick, with hyperenhancement and inflammation progressing into the cecum. General Surgery was consulted and patient admitted to hospital for management of this small bowel obstruction.


Changed on 5/14/2021

VAERS ID: 903931 Before After
VAERS Form:2
Age:29.0
Sex:Male
Location:Washington
Vaccinated:2020-12-17
Onset:2020-12-18
Submitted:0000-00-00
Entered:2020-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / SYR

Administered by: Military      Purchased by: ??
Symptoms: Abdominal pain, Blood creatinine increased, C-reactive protein increased, Computerised tomogram abnormal, Dehydration, Haematocrit increased, Small intestinal obstruction, Computerised tomogram abdomen, Scan with contrast abnormal, Gastrointestinal inflammation, Gastrointestinal wall thickening

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Denies any home medications
Current Illness: None
Preexisting Conditions: None
Allergies: Denies any allergies allergies
Diagnostic Lab Data: 12/18/20 - CT Abdomen and Pelvis w/ Contrast
CDC 'Split Type':

Write-up: Presented with periumbilical pain to emergency department (patient works at Medical Center). Admitted to hospital for small bowel obstruction. Labs were consistent with dehydration (Hct 55, Cr 1.25), as well as CRP 1.10. A CT Abd/Pelvis identified proximal dilation and fecalization of small bowel, with a transition point in the left lower quadrant. Distal to the transition point, the small bowel appears thick, with hyperenhancement and inflammation progressing into the cecum. General Surgery was consulted and patient admitted to hospital for management of this small bowel obstruction.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=903931&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166