harishnair04/mtsamples huggingface dataset:
Colonoscopy - 3 
Medical specialty:  Gastroenterology
 Colonoscopy to evaluate prior history of neoplastic polyps.

PREOPERATIVE DIAGNOSIS:,  Prior history of neoplastic polyps.,POSTOPERATIVE DIAGNOSIS:,  Small rectal polyps/removed and fulgurated.,PREMEDICATIONS:,  Prior to the colonoscopy, the patient complained of a sever headache and she was concerned that she might become ill.  I asked the nurse to give her 25 mg of Demerol IV.,Following the IV Demerol, she had a nausea reaction.  She was then given 25 mg of Phenergan IV.  Following this, her headache and nausea completely resolved.  She was then given a total of 7.5 mg of Versed with adequate sedation.  Rectal exam revealed no external lesions.  Digital exam revealed no mass.,REPORTED PROCEDURE:,  The P160 colonoscope was used.  The scope was placed in the rectal ampulla and advanced to the cecum.  Navigation through the sigmoid colon was difficult.  Beginning at 30 cm was a very tight bend.  With gentle maneuvering, the scope passed through and then entered the cecum.  The cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, and descending colon were normal.  The sigmoid colon was likewise normal.  There were five very small (punctate) polyps in the rectum.  One was resected using the electrocautery snare and the other four were ablated using the snare and cautery.  There was no specimen because the polyps were so small.  The scope was retroflexed in the rectum and no further abnormality was seen, so the scope was straightened, withdrawn, and the procedure terminated.,ENDOSCOPIC IMPRESSION:,1.  Five small polyps as described, all fulgurated.,2.  Otherwise unremarkable colonoscopy.
Colonoscopy - 6 
Medical specialty:  Gastroenterology
 Colonoscopy to screen for colon cancer

INDICATIONS: , This is a 55-year-old female who is having a colonoscopy to screen for colon cancer.  There is no family history of colon cancer and there has been no blood in the stool.,PROCEDURE PERFORMED:  ,Colonoscopy.,PREP: , Fentanyl 100 mcg IV and 3 mg Versed IV.,PROCEDURE:,  The tip of the endoscope was introduced into the rectum.  Retroflexion of the tip of the endoscope failed to reveal any distal rectal lesions.  The rest of the colon through to the cecum was well visualized.  The cecal strap, ileocecal valve, and light reflex in the right lower quadrant were all identified.  There was no evidence of tumor, polyp, mass, ulceration, or other focus of inflammation.  Adverse reactions none.,IMPRESSION:,  Normal colonic mucosa through to the cecum.  There was no evidence of tumor or polyp.
Colonoscopy - 20 
Medical specialty:  Gastroenterology
 Screening colonoscopy.  Tiny polyps.   If adenomatous, repeat exam in five years.  

PREOPERATIVE DIAGNOSIS: , Screening. ,POSTOPERATIVE DIAGNOSIS:,  Tiny Polyps.,PROCEDURE PERFORMED:  , Colonoscopy.,PROCEDURE:  , The procedure, indications, and risks were explained to the patient, who understood and agreed.  He was sedated with Versed 3 mg, Demerol 25 mg during the examination.  ,A digital rectal exam was performed and the Pentax Video Colonoscope was advanced over the examiner's finger into the rectum.  It was passed to the level of the cecum.  The ileocecal valve was identified, as was the appendiceal orifice.  ,Slowly withdrawal through the colon revealed a small polyp in the transverse colon.  This was approximately 3 mm in size and was completely removed using multiple bites with cold biopsy forceps.  In addition, there was a 2 mm polyp versus lymphoid aggregate in the descending colon.  This was also removed using the cold biopsy forceps.  Further detail failed to reveal any other lesions with the exception of small hemorrhoids.  ,IMPRESSION:  , Tiny polyps.  ,PLAN:  , If adenomatous, repeat exam in five years.  Otherwise, repeat exam in 10 years.,
Colonoscopy - 21 
Medical specialty:  Gastroenterology
 Colonoscopy and biopsies, epinephrine sclerotherapy, hot biopsy cautery, and snare polypectomy.  Colon cancer screening.  Family history of colon polyps.

OPERATIVE PROCEDURES: , Colonoscopy and biopsies, epinephrine sclerotherapy, hot biopsy cautery, and snare polypectomy.,PREOPERATIVE DIAGNOSES:,1.  Colon cancer screening.,2.  Family history of colon polyps.,POSTOPERATIVE DIAGNOSES:,1.  Multiple colon polyps (5).,2.  Diverticulosis, sigmoid colon.,3.  Internal hemorrhoids.,ENDOSCOPE USED: , EC3870LK.,BIOPSIES:  ,Biopsies taken from all polyps.  Hot biopsy got applied to one.  Epinephrine sclerotherapy and snare polypectomy applied to four polyps.,ANESTHESIA: , Fentanyl 75 mcg, Versed 6 mg, and glucagon 1.5 units IV push in divided doses.  Also given epinephrine 1:20,000 total of 3 mL.,The patient tolerated the procedure well.,PROCEDURE:  ,The patient was placed in left lateral decubitus after appropriate sedation.  Digital rectal examination was done, which was normal.  Endoscope was introduced and passed through a rather spastic tortuous sigmoid colon with multiple diverticula seen all the way through transverse colon where about 1 cm x 1 cm sessile polyp was seen.  It was biopsied and then in piecemeal fashion removed using snare polypectomy after base was infiltrated with epinephrine.  Pedunculated polyp next to it was hard to see and there was a lot of peristalsis.  The scope then was advanced through rest of the transverse colon to ascending colon and cecum.  Terminal ileum was briefly reviewed, appeared normal and so did cecum after copious amount of fecal material was irrigated out.  Ascending colon was unremarkable.  At hepatic flexure may be proximal transverse colon, there was a sessile polyp about 1.2 cm x 1 cm that was removed in the same manner with a biopsy taken, base infiltrated with epinephrine and at least two passes of snare polypectomy and subsequent hot biopsy cautery removed to hold polypoid tissue, which could be seen.  In transverse colon on withdrawal and relaxation with epinephrine, an additional 1 mm to 2 mm sessile polyp was removed by hot biopsy.  Then in the transverse colon, additional larger polyp about 1.3 cm x 1.2 cm was removed in piecemeal fashion again with epinephrine, sclerotherapy, and snare polypectomy.  Subsequently pedunculated polyp in distal transverse colon near splenic flexure was removed with snare polypectomy.  The rest of the splenic flexure and descending colon were unremarkable.  Diverticulosis was again seen with almost constant spasm despite of glucagon.  Sigmoid colon did somewhat hinder the inspection of that area.  Rectum, retroflexion posterior anal canal showed internal hemorrhoids moderate to large.  Excess of air insufflated was removed.  The endoscope was withdrawn.,PLAN: , Await biopsy report.  Pending biopsy report, recommendation will be made when the next colonoscopy should be done at least three years perhaps sooner besides and due to multitude of the patient's polyps.
Colonoscopy - 22 
Medical specialty:  Gastroenterology
 Mild-to-moderate diverticulosis.  She was referred for a screening colonoscopy.  There is no family history of colon cancer.  No evidence of polyps or malignancy.

PROCEDURE: , Colonoscopy.,PREOPERATIVE DIAGNOSES:,  The patient is a 56-year-old female.  She was referred for a screening colonoscopy.  The patient has bowel movements every other day.  There is no blood in the stool, no abdominal pain.  She has hypertension, dyslipidemia, and gastroesophageal reflux disease.  She has had cesarean section twice in the past.  Physical examination is unremarkable.  There is no family history of colon cancer.,POSTOPERATIVE DIAGNOSIS: , Diverticulosis.,PROCEDURE IN DETAIL: , Procedure and possible complications were explained to the patient.  Ample opportunity was provided to her to ask questions.  Informed consent was obtained.  She was placed in left lateral position.  Inspection of perianal area was normal.  Digital exam of the rectum was normal.,Video Olympus colonoscope was introduced into the rectum.  The sigmoid colon is very tortuous.  The instrument was advanced to the cecum after placing the patient in a supine position.  The patient was well prepared and a good examination was possible.  The cecum was identified by the ileocecal valve and the appendiceal orifice.  Images were taken.  The instrument was then gradually withdrawn while examining the colon again in a circumferential manner.  Few diverticula were encountered in the sigmoid and descending colon.  Retroflex view of the rectum was unremarkable.  No polyps or malignancy was identified.,After obtaining images, the air was suctioned.  Instrument was withdrawn from the patient.  The patient tolerated the procedure well.  There were no complications.,SUMMARY OF FINDINGS:  ,Colonoscopy was performed to cecum and demonstrates the following:,1.  Mild-to-moderate diverticulosis.,2.  ,RECOMMENDATION:,1.  The patient was provided information on diverticulosis including dietary advice.,2.  She was advised repeat colonoscopy after 10 years.
Colonoscopy - 19 
Medical specialty:  Gastroenterology
 Colonoscopy with terminal ileum examination.   Iron deficiency anemia.  Following titrated intravenous sedation the flexible video endoscope was introduced into the rectum and advanced to the cecum without difficulty. 

INDICATION: , Iron deficiency anemia.,PROCEDURE:  ,Colonoscopy with terminal ileum examination.,POSTOPERATIVE DIAGNOSIS:,  Normal examination.,WITHDRAWAL TIME: , 15 minutes.,SCOPE: , CF-H180AL.,MEDICATIONS: , Fentanyl 100 mcg and versed 10 mg.,PROCEDURE DETAIL:  ,Following the preprocedure patient assessment the procedure, goals, risks including bleeding, perforation, missed polyp rate as well as side effects of medications and alternatives were reviewed.  Questions were answered.  Pause preprocedure was performed.,Following titrated intravenous sedation the flexible video endoscope was introduced into the rectum and advanced to the cecum without difficulty.  The ileocecal valve looked normal.  Preparation was fair allowing examination of 85% of mucosa after washing and cleaning with tap water through the scope.  The terminal ileum was intubated through the ileocecal valve for a 5 cm extent.  Terminal ileum mucosa looked normal.,Then the scope was withdrawn while examining the mucosa carefully including the retroflexed views of the rectum.  No polyp, no diverticulum and no bleeding source was identified.,The patient was assessed upon completion of the procedure.  Okay to discharge once criteria met.  ,RECOMMENDATIONS:,  Follow up with primary care physician.
Colonoscopy - 17 
Medical specialty:  Gastroenterology
 Universal diverticulosis and nonsurgical internal hemorrhoids. Total colonoscopy with photos.  The patient is a 62-year-old white male who presents to the office with a history of colon polyps and need for recheck.

PREOPERATIVE DIAGNOSIS: , Colon polyps.,POSTOPERATIVE DIAGNOSES:,1.  Universal diverticulosis.,2.  Nonsurgical internal hemorrhoids.,PROCEDURE PERFORMED:, Total colonoscopy with photos.,ANESTHESIA:,  Demerol 100 mg IV with Versed 3 mg IV.,SPECIMENS: , None.,ESTIMATED BLOOD LOSS: , Minimal.,INDICATIONS FOR PROCEDURE:  ,The patient is a 62-year-old white male who presents to the office with a history of colon polyps and need for recheck.,PROCEDURE:,  Informed consent was obtained.  All risks and benefits of the procedure were explained and all questions were answered.  The patient was brought back to the Endoscopy Suite where he was connected to cardiopulmonary monitoring.  Demerol 100 mg IV and Versed 3 mg IV was given in a titrated fashion until appropriate anesthesia was obtained.  Upon appropriate anesthesia, a digital rectal exam was performed, which showed no masses.  The colonoscope was then placed into the anus and the air was insufflated.  The scope was then advanced under direct vision into the rectum, rectosigmoid colon, descending colon, transverse colon, ascending colon until it reached the cecum.  Upon entering the sigmoid colon and throughout the rest of the colon, there was noted diverticulosis.  After reaching the cecum, the scope was fully withdrawn visualizing all walls again noting universal diverticulosis.,Upon reaching the rectum, the scope was then retroflexed upon itself and there was noted to be nonsurgical internal hemorrhoids.  The scope was then subsequently removed.  The patient tolerated the procedure well and there were no complications.
Colonoscopy - 18 
Medical specialty:  Gastroenterology
 Possible inflammatory bowel disease.  Polyp of the sigmoid colon..  Total colonoscopy with photography and polypectomy.

PREOPERATIVE DIAGNOSIS: , Possible inflammatory bowel disease.,POSTOPERATIVE DIAGNOSIS: , Polyp of the sigmoid colon.,PROCEDURE PERFORMED:  ,Total colonoscopy with photography and polypectomy.,GROSS FINDINGS: , The patient had a history of ischiorectal abscess.  He has been evaluated now for inflammatory bowel disease.  Upon endoscopy, the colon prep was good.  We were able to reach the cecum without difficulty.  There are no diverticluli, inflammatory bowel disease, strictures, or obstructing lesions.  There was a pedunculated polyp approximately 4.5 cm in size located in the sigmoid colon at approximately 35 cm.  This large polyp was removed using the snare technique.,OPERATIVE PROCEDURE:  ,The patient was taken to the endoscopy suite, prepped and draped in left lateral decubitus position.  IV sedation was given by Anesthesia Department.  The Olympus videoscope was inserted into anus.  Using air insufflation, the colonoscope was advanced through the anus to the rectum, sigmoid colon, descending colon, transverse colon, ascending colon and cecum, the above gross findings were noted.  The colonoscope was slowly withdrawn and carefully examined the lumen of the bowel.  When the polyp again was visualized, the snare was passed around the polyp.  It required at least two to three passes of the snare to remove the polyp in its totality.  There was a large stalk on the polyp.  ________ the polyp had been removed down to the junction of the polyp in the stalk, which appeared to be cauterized and no residual adenomatous tissue was present.  No bleeding was identified.  The colonoscope was then removed and patient was sent to recovery room in stable condition.
Colonoscopy - 14 
Medical specialty:  Gastroenterology
 Colonoscopy. History of colon polyps and partial colon resection, right colon.  Mild diverticulosis of the sigmoid colon.  Hemorrhoids.

PREPROCEDURE DIAGNOSIS: , History of colon polyps and partial colon resection, right colon.,POSTPROCEDURE DIAGNOSES:  ,1. Normal operative site.  ,2. Mild diverticulosis of the sigmoid colon.  ,3. Hemorrhoids.,PROCEDURE:  ,Total colonoscopy.,PROCEDURE IN DETAIL:  ,The patient is a 60-year-old of Dr. ABC's being evaluated for the above.  The patient also apparently had an x-ray done at the Hospital and it showed a dark spot, and because of this, a colonoscopy was felt to be needed.  She was prepped the night before and on the morning of the test with oral Fleet's, brought to the second floor and sedated with a total of 50 mg of Demerol and 3.75 mg of Versed IV push.  Digital rectal exam was done, unremarkable.  At that point, the Pentax video colonoscope was inserted.  The rectal vault appeared normal.  The sigmoid showed diverticula throughout, mild to moderate in nature.  The scope was then passed through the descending and transverse colon over to the hepatic flexure area and then the anastomosis site was visualized.  The scope was passed a short distance up the ileum, which appeared normal.  The scope was then withdrawn through the transverse, descending, sigmoid, and rectal vault area.  The scope was then retroflexed, and anal verge visualized showed some hemorrhoids.  The scope was then removed.  The patient tolerated the procedure well.,RECOMMENDATIONS:  ,Repeat colonoscopy in three years.
Colonoscopy - 2 
Medical specialty:  Gastroenterology
 Colonoscopy in a patient with prior history of anemia and abdominal bloating.

PREOPERATIVE DIAGNOSES:,  Prior history of anemia, abdominal bloating.,POSTOPERATIVE DIAGNOSIS:,  External hemorrhoids, otherwise unremarkable colonoscopy.,PREMEDICATIONS:,  Versed 5 mg, Demerol 50 mg IV.,REPORT OF PROCEDURE:,  Digital rectal exam revealed external hemorrhoids.  The colonoscope was inserted into the rectal ampulla and advanced to the cecum.  The position of the scope within the cecum was verified by identification of the appendiceal orifice.  The cecum, the ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, and rectum were normal.  The scope was retroflexed in the rectum and no abnormality was seen.  So the scope was straightened, withdrawn, and the procedure terminated.,ENDOSCOPIC IMPRESSION:,1.  Normal colonoscopy.,2.  External hemorrhoids.
Colonoscopy - 16 
Medical specialty:  Gastroenterology
 Colonoscopy.   Rectal bleeding and perirectal abscess.  Normal colonoscopy to the terminal ileum.  Opening in the skin at the external anal verge, consistent with drainage from a perianal abscess, with no palpable abscess at this time, and with no evidence of fistulous connection to the bowel lumen.

PROCEDURE: , Colonoscopy.,PREOPERATIVE DIAGNOSES: , Rectal bleeding and perirectal abscess.,POSTOPERATIVE DIAGNOSIS: , Perianal abscess.,MEDICATIONS:,  MAC.,DESCRIPTION OF PROCEDURE:  ,The Olympus pediatric variable colonoscope was introduced through the rectum and advanced carefully through the colon into the cecum and then through the ileocecal valve into the terminal ileum.  The preparation was excellent and all surfaces were well seen.  The mucosa throughout the colon and in the terminal ileum was normal, with no evidence of colitis.  Special attention was paid to the rectum, including retroflexed views of the distal rectum and the anorectal junction.  There was no evidence of either inflammation or a fistulous opening.  The scope was withdrawn.  A careful exam of the anal canal and perianal area demonstrated a jagged 8-mm opening at the anorectal junction posteriorly (12 o'clock position).  Some purulent material could be expressed through the opening.  There was no suggestion of significant perianal reservoir of inflamed tissue or undrained material.  Specifically, the posterior wall of the distal rectum and anal canal were soft and unremarkable.  In addition, scars were noted in the perianal area.  The first was a small dimpled scar, 1 cm from the anal verge in the 11 o'clock position.  The second was a dimpled scar about 5 cm from the anal verge on the left buttock's cheek.  There were no other abnormalities noted.  The patient tolerated the procedure well and was sent to the recovery room.,FINAL DIAGNOSES:,1.  Normal colonoscopy to the terminal ileum.,2.  Opening in the skin at the external anal verge, consistent with drainage from a perianal abscess, with no palpable abscess at this time, and with no evidence of fistulous connection to the bowel lumen.,RECOMMENDATIONS:,1.  Continue antibiotics.,2.  Followup with Dr. X.,3.  If drainage persists, consider surgical drainage.
Colonoscopy - 13 
Medical specialty:  Gastroenterology
 History of polyps.  Total colonoscopy and photography.  Normal colonoscopy, left colonic diverticular disease.  3+ benign prostatic hypertrophy.

PREOPERATIVE DIAGNOSIS: , History of polyps.,POSTOPERATIVE DIAGNOSES:,1.  Normal colonoscopy, left colonic diverticular disease.,2.  3+ benign prostatic hypertrophy.,PROCEDURE PERFORMED: , Total colonoscopy and photography.,GROSS FINDINGS: , This is a 74-year-old white male here for recheck colonoscopy for a history of polyps.  After signed informed consent, blood pressure monitoring, EKG monitoring, and pulse oximetry monitoring, he was brought to the Endoscopic Suite.  He was given 100 mg of Demerol, 3 mg of Versed IV push slowly.  Digital examination revealed a large prostate for which he is following up with his urologist.  No nodules.  3+ BPH.  Anorectal canal was within normal limits.  No stricture tumor or ulcer.  The Olympus CF 20L video endoscope was inserted per anus.  The anorectal canal was visualized, was normal.  The sigmoid, descending, splenic, and transverse showed scattered diverticula.  The hepatic, ascending, cecum, and ileocecal valve was visualized and was normal.  The colonoscope was removed.  The air was aspirated.  The patient was discharged with high-fiber, diverticular diet.  Recheck colonoscopy three years.
Colonoscopy - 15 
Medical specialty:  Gastroenterology
 Colonoscopy.  Change in bowel habits and rectal prolapse.  Normal colonic mucosa to the cecum.  

PROCEDURE:,  Colonoscopy.,PREOPERATIVE DIAGNOSES: , Change in bowel habits and rectal prolapse.,POSTOPERATIVE DIAGNOSIS: , Normal colonoscopy.,PROCEDURE:  ,The Olympus pediatric variable colonoscope was introduced through the rectum and advanced carefully through the colon to the cecum identified by the ileocecal valve and the appendiceal orifice.  The preparation was poor, but mucosa was visible after lavage and suction.  Small lesions might have been missed in certain places, but no large lesions are likely to have been missed.  The mucosa was normal, was visualized.  In particular, there was no mucosal abnormality in the rectum and distal sigmoid, which is reported to be prolapsing.  Biopsies were taken from the rectal wall to look for microscopic changes.  The anal sphincter was considerably relaxed, with no tone and a gaping opening.  The patient tolerated the procedure well and was sent to recovery room.,FINAL DIAGNOSIS: , Normal colonic mucosa to the cecum.  No contraindications to consideration of a repair of the prolapse.
Colon Cancer Screening 
Medical specialty:  Gastroenterology
 Routine colorectal cancer screening.  He occasionally gets some loose stools.  

HISTORY AND REASON FOR CONSULTATION:, For evaluation of this patient for colon cancer screening.,HISTORY OF PRESENT ILLNESS:, Mr. A is a 53-year-old gentleman who was referred for colon cancer screening.  The patient said that he occasionally gets some loose stools.  Other than that, there are no other medical problems. ,PAST MEDICAL HISTORY:, The patient does not have any serious medical problems at all.  He denies any hypertension, diabetes, or any other problems.  He does not take any medications.,PAST SURGICAL HISTORY: ,Surgery for deviated nasal septum in 1996.,ALLERGIES:, No known drug allergies.,SOCIAL HISTORY: ,Does not smoke, but drinks occasionally for the last five years.,FAMILY HISTORY:, There is no history of any colon cancer in the family.,REVIEW OF SYSTEMS:, Denies any significant diarrhea.  Sometimes he gets some loose stools.  Occasionally there is some constipation.  Stools caliber has not changed.  There is no blood in stool or mucus in stool.  No weight loss.  Appetite is good.  No nausea, vomiting, or difficulty in swallowing.  Has occasional heartburn.,PHYSICAL EXAMINATION:, The patient is alert and oriented x3.  Vital signs: Weight is 214 pounds.  Blood pressure is 111/70.  Pulse is 69 per minute.  Respiratory rate is 18.  HEENT: Negative.  Neck: Supple.  There is no thyromegaly.  Cardiovascular: Both heart sounds are heard.  Rhythm is regular.  No murmur.  Lungs: Clear to percussion and auscultation.  Abdomen: Soft and nontender.  No masses felt.  Bowel sounds are heard.  Extremities: Free of any edema.,IMPRESSION: ,Routine colorectal cancer screening.,RECOMMENDATIONS:, Colonoscopy.  I have explained the procedure of colonoscopy with benefits and risks, in particular the risk of perforation, hemorrhage, and infection.  The patient agreed for it.  We will proceed with it.  I also explained to the patient about conscious sedation.  He agreed for conscious sedation.