Sex: F
Vaccine: TYP
Symptoms: Intestinal obstruction, Procedural nausea, Vomiting
Clinical narrative: Gastrointestinal obstruction/Intestinal blockage; Spontaneous report received on 29JAN2020. Additional information received on 30JAN2020.  A consumer's sister reported that her 69-year-old sister had gastrointestinal obstruction/intestinal blockage (PT: Gastrointestinal obstruction) while being on Vivotif for immunisation. The consumer took first and second dose of Vivotif on 20JAN2020 and 22JAN2020 respectively. The consumer took third dose of Vivotif on an unknown date. She started throwing up and had severe stomach ache in the evening of 25JAN2020. She also had uncontrolled vomiting and intestinal cramping. She was hospitalised on 26Jan2020 (in the morning) with an intestinal blockage. At the time of hospitalisation, she had severe vomiting, stomach cramps and extreme abdominal pain. Many diagnostic tests were performed to determine the exact blockage but all of them were unable to find the exact blockage as the faeces were spread throughout the colon. Nasogastric tube (NG) was inserted which helped temporarily, but did not resolve the problem and later when it was removed, she began vomiting again. She was unable to pass a bowel movement (BM) as colon was blocked the whole time. She was administered with Miralax (polyethylene glycol 3350) and an enema was performed but they did not help. She started throwing up faeces and it was decided to perform an abdominal surgery to open up the obstruction. On 29JAN2020, an abdominal surgery was successfully performed, and they were able to open up the GI obstruction. The obstruction was related to adhesion in gastrointestinal tract. The reporter stated that the medical team did not perform resection as the adhesion had choked and closed up the intestines and they were able to reopen it. The medical team did not have a definitive diagnosis and they have not determined an attributable cause. She stated that it could have been due to a prior abdominal surgery. She further stated that her sister finally stopped vomiting for the first time after 4 days but was having symptoms related to post-surgical nausea. She still had an NG tube in place and was receiving anti-nausea medications via a "pouch". Action taken with Vivotif with respect to the reported event was unknown. The consumer was recovering from the reported event.  Medical history included polycystic ovary syndrome and ruptured cysts. She underwent hysterectomy after ruptured cysts.  Concurrent medical condition included genetic issues with Factor V clotting disorder, and also hypothyroidism.   Concomitant medication included levothyroxine for hypothyroidism.  Company Comment: A consumer took three doses of Vivotif and then was admitted in the hospital for gastrointestinal obstruction. The consumer has a history of polycystic ovarian disease, ruptured cysts and hysterectomy. At the hospital, conservative measures did not relieve consumer's symptoms and an abdominal surgery was performed, and successfully opened up the obstruction. It was found that the consumer had gastrointestinal (GI) adhesions (probably from previous abdominal surgery) which blocked the intestines. The consumer was recovering in the hospital and was having post-operative nausea. Considering the case information, Vivotif could not have caused GI adhesions leading to GI obstruction, and the causality of the event is assessed as not related to Vivotif (attributed to prior abdominal surgery which led to GI adhesions and obstruction). Consumer's symptoms of vomiting, unable pass bowel movements, campy abdominal pain was subsumed under gastrointestinal obstruction. The case is considered serious as the event needed hospitalization and an abdominal surgery. Gastrointestinal obstruction is unlisted as per CCDS.; Sender's Comments: A consumer took three doses of Vivotif and then was admitted in the hospital for gastrointestinal obstruction. The consumer has a history of polycystic ovarian disease, ruptured cysts and hysterectomy. At the hospital, conservative measures did not relieve consumer's symptoms and an abdominal surgery was performed, and successfully opened up the obstruction. It was found that the consumer had gastrointestinal (GI) adhesions (probably from previous abdominal surgery) which blocked the intestines. The consumer was recovering in the hospital and was having post-operative nausea. Considering the case information, Vivotif could not have caused GI adhesions leading to GI obstruction, and the causality of the event is assessed as not related to Vivotif (attributed to prior abdominal surgery which led to GI adhesions and obstruction). Consumer's symptoms of vomiting, unable pass bowel movements, campy abdominal pain was subsumed under gastrointestinal obstruction. The case is considered serious as the event needed hospitalization and an abdominal surgery. Gastrointestinal obstruction is unlisted as per CCDS.