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The operation was completed with a double suction drainage. | [
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] | A 50-years-old woman, hypertensive, hospitalized for a large cervical mass appeared 30 years ago. In the family history, her mother, sisters and cousins underwent a surgery for MNG. Despite of the large volume of the mass, the patient never described signs of cervical compression whatsoever respiratory, digestive, lary... | EN100067 |
In the immediate postoperative period, the patient developed hemodynamic collapse requiring the introduction of dobutamine. | [
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"text": "dobutamine",
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}... | A 50-years-old woman, hypertensive, hospitalized for a large cervical mass appeared 30 years ago. In the family history, her mother, sisters and cousins underwent a surgery for MNG. Despite of the large volume of the mass, the patient never described signs of cervical compression whatsoever respiratory, digestive, lary... | EN100067 |
After 48 hours of hemodynamic support, the blood pressure stabilized and dobutamine was stopped. | [
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{... | A 50-years-old woman, hypertensive, hospitalized for a large cervical mass appeared 30 years ago. In the family history, her mother, sisters and cousins underwent a surgery for MNG. Despite of the large volume of the mass, the patient never described signs of cervical compression whatsoever respiratory, digestive, lary... | EN100067 |
Histological study concluded in multinodular colloid goiter. | [
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... | A 50-years-old woman, hypertensive, hospitalized for a large cervical mass appeared 30 years ago. In the family history, her mother, sisters and cousins underwent a surgery for MNG. Despite of the large volume of the mass, the patient never described signs of cervical compression whatsoever respiratory, digestive, lary... | EN100067 |
The patient was discharged from the hospital after 20 days in good health. | [
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"text": "discharged",
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"text": "The patient",
"type": "ACT... | A 50-years-old woman, hypertensive, hospitalized for a large cervical mass appeared 30 years ago. In the family history, her mother, sisters and cousins underwent a surgery for MNG. Despite of the large volume of the mass, the patient never described signs of cervical compression whatsoever respiratory, digestive, lary... | EN100067 |
A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. | [
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"role": "",
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"text": "gestation",
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"text": "presented",
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... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. | [
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"text": "pain",
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{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Pain had gradually worsened over the months with no known relieving or aggravating factors but with intermittent radiation to the chest. | [
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"text": "Pain",
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"text": "worsened",
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... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
There was a history of significant weight loss but no associated early satiety, jaundice, fever, itch or spontaneous bleeding. | [
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"id": "8439",
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"role": "",
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"text": "loss",
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"role": "",
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"text": "satiety",
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{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
No history of blood transfusion and patient was on her routine hematinic from the antenatal clinic (ANC). | [
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"role": "",
"semantic_type_id": "",
"text": "transfusion",
"type": "EVENT"
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{
"id": "8544",
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"role": "",
"semantic_type_id": "",
"text": "hematinic",
"type": "EVENT"
}... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
She is not a known diabetic, Hypertensive and has no known chronic illness. | [
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"id": "8559",
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"role": "",
"semantic_type_id": "",
"text": "diabetic",
"type": "EVENT"
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"role": "",
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"text": "Hypertensive",
"type": "EVENT"
}... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Patient did not know her Hepatitis status. | [
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"role": "",
"semantic_type_id": "",
"text": "know",
"type": "EVENT"
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"id": "8619",
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"role": "",
"semantic_type_id": "",
"text": "Hepatitis",
"type": "EVENT"
},
{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Denied to taking any alcohol or smoking. | [
{
"id": "8634",
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"role": "",
"semantic_type_id": "",
"text": "Denied",
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{
"id": "8649",
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"role": "",
"semantic_type_id": "",
"text": "taking",
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{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
There were no cardiorespiratory nor urogenital symptoms. | [
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"id": "8679",
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"role": "",
"semantic_type_id": "",
"text": "symptoms",
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] | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
She did not store grains at home and had no known contact with chemicals or ionizing radiation. | [
{
"id": "8694",
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17
],
"role": "",
"semantic_type_id": "",
"text": "store",
"type": "EVENT"
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{
"id": "8709",
"offsets": [
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"role": "",
"semantic_type_id": "",
"text": "contact",
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{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Clinical signs on examination included wasting, mild pallor, a tinge of jaundice but well hydrated, afebrile and no palpable lymphnodes. | [
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14
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"role": "",
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"text": "signs",
"type": "EVENT"
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"id": "8739",
"offsets": [
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"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
She had palmer erythema but no clubbing and parotid enlargement. | [
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"role": "",
"semantic_type_id": "",
"text": "erythema",
"type": "EVENT"
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{
"id": "8844",
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"role": "",
"semantic_type_id": "",
"text": "clubbing",
"type": "EVENT"
},
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Respiratory, cardiovascular and neurological examinations were unremarkable. | [
{
"id": "8874",
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"role": "",
"semantic_type_id": "",
"text": "examinations",
"type": "EVENT"
},
{
"id": "8889",
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75
],
"role": "",
"semantic_type_id": "",
"text": "unremarkable",
"type": "EVENT"... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Abdomen was grossly distended with distorted contour in the upper half and visibly distended anterior abdominal wall veins draining away from the umbilicus. | [
{
"id": "8904",
"offsets": [
20,
29
],
"role": "",
"semantic_type_id": "",
"text": "distended",
"type": "EVENT"
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{
"id": "8919",
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"role": "",
"semantic_type_id": "",
"text": "contour",
"type": "EVENT"
},
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Liver was enlarged 12cm below the costal margin with a span of 17cm. | [
{
"id": "8949",
"offsets": [
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18
],
"role": "",
"semantic_type_id": "",
"text": "enlarged",
"type": "EVENT"
},
{
"id": "10121",
"offsets": [
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5
],
"role": "",
"semantic_type_id": "",
"text": "Liver",
"type": "BODYPART"
},
{... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
The liver was hard, nodular with irregular edge, mild tendernes and had a bruit on auscultation. | [
{
"id": "8964",
"offsets": [
14,
18
],
"role": "",
"semantic_type_id": "",
"text": "hard",
"type": "EVENT"
},
{
"id": "8979",
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],
"role": "",
"semantic_type_id": "",
"text": "nodular",
"type": "EVENT"
},
{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
The spleen was not palpable but with demonstrable mild ascites and bipedal eodema up to the mid shin. | [
{
"id": "9039",
"offsets": [
19,
27
],
"role": "",
"semantic_type_id": "",
"text": "palpable",
"type": "EVENT"
},
{
"id": "9054",
"offsets": [
55,
62
],
"role": "",
"semantic_type_id": "",
"text": "ascites",
"type": "EVENT"
},
{... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Symphysio fundal height was 26 cm, with longitudinal lie and breech presentation. | [
{
"id": "9084",
"offsets": [
17,
23
],
"role": "",
"semantic_type_id": "",
"text": "height",
"type": "EVENT"
},
{
"id": "9099",
"offsets": [
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56
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"role": "",
"semantic_type_id": "",
"text": "lie",
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},
{
"... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Fetal heart rate was 134 bpm and regular. | [
{
"id": "9129",
"offsets": [
12,
16
],
"role": "",
"semantic_type_id": "",
"text": "rate",
"type": "EVENT"
},
{
"id": "9144",
"offsets": [
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40
],
"role": "",
"semantic_type_id": "",
"text": "regular",
"type": "EVENT"
},
{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Rectal and vaginal examination were unremarkable. | [
{
"id": "9159",
"offsets": [
19,
30
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "9174",
"offsets": [
36,
48
],
"role": "",
"semantic_type_id": "",
"text": "unremarkable",
"type": "EVENT"
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Initial diagnosis of hepatocellular Carcinoma in pregnancy was made. | [
{
"id": "9189",
"offsets": [
36,
45
],
"role": "",
"semantic_type_id": "",
"text": "Carcinoma",
"type": "EVENT"
}
] | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Laboratory assesment revealed HB-10.3g/dl, WBC 10200 cells/dl; Neutrophils 59.3%, lymphocytes 26.1%, Monocytes 10.1% and Eosinophils 2.7%. | [
{
"id": "9204",
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"role": "",
"semantic_type_id": "",
"text": "assesment",
"type": "EVENT"
},
{
"id": "9219",
"offsets": [
21,
29
],
"role": "",
"semantic_type_id": "",
"text": "revealed",
"type": "EVENT"
},
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Platelets 350000/ul. | [
{
"id": "9324",
"offsets": [
0,
9
],
"role": "",
"semantic_type_id": "",
"text": "Platelets",
"type": "EVENT"
},
{
"id": "10332",
"offsets": [
10,
19
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"role": "",
"semantic_type_id": "",
"text": "350000/ul",
"type": "RML"
}
] | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Normal bilirubin but GGT and AST were raised (4 times upper limit). | [
{
"id": "9339",
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21,
24
],
"role": "",
"semantic_type_id": "",
"text": "GGT",
"type": "EVENT"
},
{
"id": "9354",
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32
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"role": "",
"semantic_type_id": "",
"text": "AST",
"type": "EVENT"
},
{
"id"... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Total protein and albumin were low, 44g/L and 29g/L respectively with INR-1.3.HBsAg was positive, HBeAg negative with HBV DNA level of 126869 IU/ml \(Viral load). | [
{
"id": "9384",
"offsets": [
6,
13
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"role": "",
"semantic_type_id": "",
"text": "protein",
"type": "EVENT"
},
{
"id": "9399",
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18,
25
],
"role": "",
"semantic_type_id": "",
"text": "albumin",
"type": "EVENT"
},
{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
VDRL positive but TPHA not done. | [
{
"id": "9474",
"offsets": [
0,
4
],
"role": "",
"semantic_type_id": "",
"text": "VDRL",
"type": "EVENT"
},
{
"id": "9489",
"offsets": [
18,
22
],
"role": "",
"semantic_type_id": "",
"text": "TPHA",
"type": "EVENT"
},
{
"id"... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Alphafeto protein (AFP) >50000KU/L. | [
{
"id": "9504",
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10,
17
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"role": "",
"semantic_type_id": "",
"text": "protein",
"type": "EVENT"
},
{
"id": "9519",
"offsets": [
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22
],
"role": "",
"semantic_type_id": "",
"text": "AFP",
"type": "EVENT"
},
{
... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
She tested negative to HIV and HCV. | [
{
"id": "9534",
"offsets": [
4,
10
],
"role": "",
"semantic_type_id": "",
"text": "tested",
"type": "EVENT"
},
{
"id": "9549",
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26
],
"role": "",
"semantic_type_id": "",
"text": "HIV",
"type": "EVENT"
},
{
"i... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Abdominal ultrasound showed a heterogeneous coarse liver with multiple hypoechoic lessions. | [
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"role": "",
"semantic_type_id": "",
"text": "ultrasound",
"type": "EVENT"
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27
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"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
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... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
The liver measured 17.2cm and there was mild ascites. | [
{
"id": "9624",
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18
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"role": "",
"semantic_type_id": "",
"text": "measured",
"type": "EVENT"
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"role": "",
"semantic_type_id": "",
"text": "ascites",
"type": "EVENT"
},
{... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Pelvic scan revealed a 27 week, 3 day old fetus, with active fetal movements. | [
{
"id": "9654",
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7,
11
],
"role": "",
"semantic_type_id": "",
"text": "scan",
"type": "EVENT"
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{
"id": "9669",
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"text": "revealed",
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... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
A revised diagnosis of hepatocellular carcinoma on a cirrhotic liver with decompensation in pregnancy was made. | [
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She was managed with analgesia, furosemide, spironolactone and lamivudine added for prevention of mother to child trasmission of the hepatitis B infection. | [
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... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
The plan was to allow pregnancy to continue to at least 32 completed weeks to improve the chance of neonatal survival. | [
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However because of the progressive unbearable abdominal pain, pregnancy was terminated at 30 weeks 3days by successful induction of labour. | [
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The outcome was a fresh stillbirth weight 1.2kg. | [
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... | A 36 year old female farmer gravida 5 para 4 at 27 weeks gestation presented to our facility. Her main complaint was a 3 month history of epigastric abdominal pain, which was gradual in onset, dull and persistent. Pain had gradually worsened over the months with no known relieving or aggravating factors but with interm... | EN100265 |
Pain was markedly reduced post delivery and was discharged home after 5 days. | [
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She was booked for a follow up visit at the gastrointestinal clinic. | [
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She was seen at the clinic at 2 weeks and four weeks post discharge but was lost to follow up afterwards. | [
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A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. | [
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He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. | [
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Computed tomography scan confirmed the presence of renal calculi that passed with conservative management. | [
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An incidental finding on the imaging showed marked pancreatic atrophy with multiple sub-centimeter calcifications consistent with severe chronic pancreatitis. | [
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Remarkably, he did not report having any symptoms associated with pancreatic insufficiency including epigastric pain, vomiting, steatorrhea and weight loss. | [
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He denied having any prior episodes of acute pancreatitis and had no history of alcohol use. | [
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... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
His laboratory tests were all within normal range, including complete blood count, liver function tests, amylase and lipase. | [
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... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
His family history was significant as his father had an isolated episode of pancreatitis which required abdominal surgery. | [
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... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
Magnetic resonance cholangiopancreatography (MRCP) showed severe parenchymal atrophy and pancreatic ductal stones with ductal dilation to 9mm. | [
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Due to his young age and atypical presentation, he was referred for genetic testing and counselling. | [
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}... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
He underwent genetic testing for various genes known to cause hereditary pancreatitis: CASR, CFTR, CTRC, PRSS1, SPINK1. | [
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... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
He tested positive for homozygous variant of SPINK1 (N34S) mutation. | [
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... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
Reflex testing of at-risk relatives confirmed that both of his parents were heterozygous carriers of the same SPINK1 (N34S) mutation and a review of their extended pedigree revealed that they were distant cousins. | [
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{... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
Given his asymptomatic clinical course, he remains under close follow-up without requiring any specific treatment for pancreatic insufficiency. | [
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{... | A 21-year-old male was referred to the gastroenterology clinic for incidental findings of severe chronic pancreatitis on cross-sectional imaging but no associated symptoms of pancreatitis. He had presented to the emergency department for abdominal pain consistent with prior episodes of renal colic. Computed tomography ... | EN100339 |
Due to the severity of pancreatitis noted on imaging and long expected lifespan, he was counselled about the increased risk of pancreatic malignancy and is undergoing regular cross-sectional imaging for the detection and prevention of cancer. | [
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We present a case of a 77-year-old Caucasian woman with obstructive jaundice. | [
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Laboratory tests revealed that she had elevated bilirubin and liver enzyme levels. | [
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A computed tomographic scan showed a homogeneous 5 × 3-cm mass obstructing the common bile duct. | [
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The results of brush cytology were consistent with a bile duct villous papilloma. | [
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... | We present a case of a 77-year-old Caucasian woman with obstructive jaundice. Laboratory tests revealed that she had elevated bilirubin and liver enzyme levels. A computed tomographic scan showed a homogeneous 5 × 3-cm mass obstructing the common bile duct. The results of brush cytology were consistent with a bile duct... | EN105094 |
However, on the basis of the tumor's radiological features, a preliminary diagnosis of extrahepatic bile duct malignant tumor was made. | [
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After discussion among the multidisciplinary team, a surgical resection of the bile duct tumor was performed. | [
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Histopathological examination confirmed a villous adenoma. | [
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The patient's postoperative course was uneventful. | [
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We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. | [
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Mild elevation of liver enzymes was found at her regular medical check-up. | [
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... | We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT) revealed a markedly dilated common bile duct (CBD... | EN108798 |
Computed tomography (CT) revealed a markedly dilated common bile duct (CBD) and two enlarged peripancreatic lymph nodes. | [
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... | We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT) revealed a markedly dilated common bile duct (CBD... | EN108798 |
Endoscopy showed that the ampulla was slightly enlarged by a submucosal tumor. | [
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{
... | We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT) revealed a markedly dilated common bile duct (CBD... | EN108798 |
The biopsy specimen revealed tumor cells that showed monotonous proliferation suggestive of a carcinoid tumor. | [
{
"id": "2106",
"offsets": [
4,
10
],
"role": "",
"semantic_type_id": "",
"text": "biopsy",
"type": "EVENT"
},
{
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"offsets": [
20,
28
],
"role": "",
"semantic_type_id": "",
"text": "revealed",
"type": "EVENT"
},
{
... | We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT) revealed a markedly dilated common bile duct (CBD... | EN108798 |
She underwent a pylorus-preserving whipple resection with lymph node dissection. | [
{
"id": "2166",
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43,
52
],
"role": "",
"semantic_type_id": "",
"text": "resection",
"type": "EVENT"
},
{
"id": "2181",
"offsets": [
69,
79
],
"role": "",
"semantic_type_id": "",
"text": "dissection",
"type": "EVENT"
},... | We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT) revealed a markedly dilated common bile duct (CBD... | EN108798 |
The resected lesion was a small submucosal tumor (7 mm in diameter) at the ampulla, with metastasis to 2 peripancreatic lymph nodes, and it was diagnosed as a malignant carcinoid tumor. | [
{
"id": "2196",
"offsets": [
13,
19
],
"role": "",
"semantic_type_id": "",
"text": "lesion",
"type": "EVENT"
},
{
"id": "2211",
"offsets": [
43,
48
],
"role": "",
"semantic_type_id": "",
"text": "tumor",
"type": "EVENT"
},
{
... | We report a case of a 63-year-old woman with a minute ampullary carcinoid tumor that was 7 mm in diameter, but was associated with 2 peripancreatic lymph node metastases. Mild elevation of liver enzymes was found at her regular medical check-up. Computed tomography (CT) revealed a markedly dilated common bile duct (CBD... | EN108798 |
A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. | [
{
"id": "7680",
"offsets": [
33,
45
],
"role": "",
"semantic_type_id": "",
"text": "hospitalized",
"type": "EVENT"
},
{
"id": "7695",
"offsets": [
73,
80
],
"role": "",
"semantic_type_id": "",
"text": "ascites",
"type": "EVENT"
},... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Her family history did not include any autoimmune disease. | [
{
"id": "7710",
"offsets": [
11,
18
],
"role": "",
"semantic_type_id": "",
"text": "history",
"type": "EVENT"
},
{
"id": "7725",
"offsets": [
50,
57
],
"role": "",
"semantic_type_id": "",
"text": "disease",
"type": "EVENT"
},
{
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
She denied a history of hepatitis, jaundice or alcohol use. | [
{
"id": "7740",
"offsets": [
24,
33
],
"role": "",
"semantic_type_id": "",
"text": "hepatitis",
"type": "EVENT"
},
{
"id": "7755",
"offsets": [
35,
43
],
"role": "",
"semantic_type_id": "",
"text": "jaundice",
"type": "EVENT"
},
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
She had a history of diabetes, hypertension treated by glinide and calcium blocker. | [
{
"id": "7785",
"offsets": [
21,
29
],
"role": "",
"semantic_type_id": "",
"text": "diabetes",
"type": "EVENT"
},
{
"id": "7800",
"offsets": [
31,
43
],
"role": "",
"semantic_type_id": "",
"text": "hypertension",
"type": "EVENT"
}... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
She was explored 4 years prior to admission for exudative pleuritis of the right lung without any established diagnosis after multiple explorations including thoracoscopy with biopsies. | [
{
"id": "7830",
"offsets": [
8,
16
],
"role": "",
"semantic_type_id": "",
"text": "explored",
"type": "EVENT"
},
{
"id": "7845",
"offsets": [
34,
43
],
"role": "",
"semantic_type_id": "",
"text": "admission",
"type": "EVENT"
},
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
On admission, blood pressure was 150/70 mmHg, her rate was 80 /mn and body temperature was 37°C. | [
{
"id": "7905",
"offsets": [
3,
12
],
"role": "",
"semantic_type_id": "",
"text": "admission",
"type": "EVENT"
},
{
"id": "7920",
"offsets": [
20,
28
],
"role": "",
"semantic_type_id": "",
"text": "pressure",
"type": "EVENT"
},
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
The physical examination showed only abdominal distension related to the important ascites without collateral venous circulation. | [
{
"id": "7965",
"offsets": [
13,
24
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "7980",
"offsets": [
25,
31
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
She had no skin lesions, lymphadenopathy, or hepatosplenomegaly and lower extremities showed no edema. | [
{
"id": "8040",
"offsets": [
16,
23
],
"role": "",
"semantic_type_id": "",
"text": "lesions",
"type": "EVENT"
},
{
"id": "8055",
"offsets": [
25,
40
],
"role": "",
"semantic_type_id": "",
"text": "lymphadenopathy",
"type": "EVENT"
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Laboratory investigations showed: leucopenia with white blood cell count = 3100/mm3, lymphopenia = 840/mm3, hemoglobin = 10.5g/dL ; low serum albumin level = 29g/L, 47;-globulin = 19g/L. blood glucose levels = 180 mg/dl and hemoglobin A1c = 8.6 %. | [
{
"id": "8115",
"offsets": [
11,
25
],
"role": "",
"semantic_type_id": "",
"text": "investigations",
"type": "EVENT"
},
{
"id": "8130",
"offsets": [
26,
32
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
}... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Urine analysis showed trace protein (0.03g/24h). | [
{
"id": "8265",
"offsets": [
6,
14
],
"role": "",
"semantic_type_id": "",
"text": "analysis",
"type": "EVENT"
},
{
"id": "8280",
"offsets": [
15,
21
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Platelet count, activated partial thromboplastin time, liver function tests, blood urea nitrogen, serum creatinine, erythrocyte sediment rate and total cholesterol were within normal limits. | [
{
"id": "8310",
"offsets": [
9,
14
],
"role": "",
"semantic_type_id": "",
"text": "count",
"type": "EVENT"
},
{
"id": "8325",
"offsets": [
49,
53
],
"role": "",
"semantic_type_id": "",
"text": "time",
"type": "EVENT"
},
{
"i... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Tests for HBsAg and HCV were negative. | [
{
"id": "8415",
"offsets": [
0,
5
],
"role": "",
"semantic_type_id": "",
"text": "Tests",
"type": "EVENT"
},
{
"id": "9843",
"offsets": [
29,
37
],
"role": "",
"semantic_type_id": "",
"text": "negative",
"type": "RML"
}
] | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Abdominal ultrasonography showed ascitic fluid without any sign of bowel loop thickening or enteritis. | [
{
"id": "8430",
"offsets": [
10,
25
],
"role": "",
"semantic_type_id": "",
"text": "ultrasonography",
"type": "EVENT"
},
{
"id": "8445",
"offsets": [
26,
32
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Neither lymphadenopathy nor liver abnormality was present. | [
{
"id": "8520",
"offsets": [
8,
23
],
"role": "",
"semantic_type_id": "",
"text": "lymphadenopathy",
"type": "EVENT"
},
{
"id": "8535",
"offsets": [
34,
45
],
"role": "",
"semantic_type_id": "",
"text": "abnormality",
"type": "EVENT... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
A chest X-ray film disclosed bilateral pleural effusion. | [
{
"id": "8550",
"offsets": [
19,
28
],
"role": "",
"semantic_type_id": "",
"text": "disclosed",
"type": "EVENT"
},
{
"id": "8565",
"offsets": [
47,
55
],
"role": "",
"semantic_type_id": "",
"text": "effusion",
"type": "EVENT"
},
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Ascitic obtained by aspiration contained 170 cells mm3 (67% lymphocytes), 46g/L protein, but no malignant cells. | [
{
"id": "8580",
"offsets": [
0,
7
],
"role": "",
"semantic_type_id": "",
"text": "Ascitic",
"type": "EVENT"
},
{
"id": "8595",
"offsets": [
8,
16
],
"role": "",
"semantic_type_id": "",
"text": "obtained",
"type": "EVENT"
},
{
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Cultures for bacteria and mycobacteria gave no growth. | [
{
"id": "8655",
"offsets": [
0,
8
],
"role": "",
"semantic_type_id": "",
"text": "Cultures",
"type": "EVENT"
},
{
"id": "8670",
"offsets": [
47,
53
],
"role": "",
"semantic_type_id": "",
"text": "growth",
"type": "EVENT"
}
] | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Tuberculosis investigation including initial tuberculin skin test and the research of Koch bacilli in sputum and urine were negative. | [
{
"id": "8685",
"offsets": [
13,
26
],
"role": "",
"semantic_type_id": "",
"text": "investigation",
"type": "EVENT"
},
{
"id": "8700",
"offsets": [
61,
65
],
"role": "",
"semantic_type_id": "",
"text": "test",
"type": "EVENT"
},
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Echocardiogram and electrocardiogram were normal. | [
{
"id": "8730",
"offsets": [
0,
14
],
"role": "",
"semantic_type_id": "",
"text": "Echocardiogram",
"type": "EVENT"
},
{
"id": "8745",
"offsets": [
19,
36
],
"role": "",
"semantic_type_id": "",
"text": "electrocardiogram",
"type": "... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Computed tomographic scan showed massive ascites, no dysmorphic liver, and a mild bilateral pleural effusion. | [
{
"id": "8760",
"offsets": [
21,
25
],
"role": "",
"semantic_type_id": "",
"text": "scan",
"type": "EVENT"
},
{
"id": "8775",
"offsets": [
26,
32
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
{
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Pelvic examination was normal. | [
{
"id": "8820",
"offsets": [
7,
18
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "9873",
"offsets": [
23,
29
],
"role": "",
"semantic_type_id": "",
"text": "normal",
"type": "RML"
}
] | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Oesogastroduodenoscopy showed hiatal hernia without oesophageal varices. | [
{
"id": "8835",
"offsets": [
0,
22
],
"role": "",
"semantic_type_id": "",
"text": "Oesogastroduodenoscopy",
"type": "EVENT"
},
{
"id": "8850",
"offsets": [
23,
29
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVE... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
An exploratory laparoscopy was performed, revealing a large amount of ascite, a normal liver appearance, and no granulations suggesting tuberculosis or peritoneal carcinosis. | [
{
"id": "8880",
"offsets": [
15,
26
],
"role": "",
"semantic_type_id": "",
"text": "laparoscopy",
"type": "EVENT"
},
{
"id": "8895",
"offsets": [
42,
51
],
"role": "",
"semantic_type_id": "",
"text": "revealing",
"type": "EVENT"
}... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Histological examination of the peritoneum showed non specific chronic inflammation. | [
{
"id": "8985",
"offsets": [
13,
24
],
"role": "",
"semantic_type_id": "",
"text": "examination",
"type": "EVENT"
},
{
"id": "9000",
"offsets": [
43,
49
],
"role": "",
"semantic_type_id": "",
"text": "showed",
"type": "EVENT"
},
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
Systemic lupus erythematosus was suspected based on pleuritis, lymphopenia and leucopenia. | [
{
"id": "9030",
"offsets": [
15,
28
],
"role": "",
"semantic_type_id": "",
"text": "erythematosus",
"type": "EVENT"
},
{
"id": "9045",
"offsets": [
33,
42
],
"role": "",
"semantic_type_id": "",
"text": "suspected",
"type": "EVENT"
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
An additional serologic survey revealed markedly elevated anti-nuclear antibody (ANA) titer of 1/1600 and a significantly elevated titer of antibody to double-stranded DNA (83 IU/mL ; normal < 30 IU/mL). | [
{
"id": "9105",
"offsets": [
24,
30
],
"role": "",
"semantic_type_id": "",
"text": "survey",
"type": "EVENT"
},
{
"id": "9120",
"offsets": [
31,
39
],
"role": "",
"semantic_type_id": "",
"text": "revealed",
"type": "EVENT"
},
{
... | A 77-year-old Tunisian woman was hospitalized because of massive painful ascites. Her family history did not include any autoimmune disease. She denied a history of hepatitis, jaundice or alcohol use. She had a history of diabetes, hypertension treated by glinide and calcium blocker. She was explored 4 years prior to a... | EN100114 |
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