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[ "EGD", "(5/10/62)", ":", "no", "evidence", "of", "recurrent", "mass", ",", "patent", "EJ", "junction" ]
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[ "CTWA", "ม.ค.", "63", ":", "no", "evidence", "of", "recurrent", "mass" ]
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[ "CTWA", "(23/5/63)", "Evidence", "of", "tumor", "seeding", "as", "described", ";" ]
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[ "•", "Enhanced", "thickening", "wall", "of", "CBD", "and", "GB", "neck", "with", "dilatation", "of", "IHD", "at", "both", "heptic", "lobes" ]
[ 0, 1, 2, 2, 2, 2, 2, 2, 2, 0, 1, 2, 2, 2, 2, 2, 2 ]
[ "•", "Enhanced", "nodular", "thickening", "at", "posterior", "and", "left", "side", "of", "urinary", "bladder", "wall" ]
[ 0, 1, 2, 2, 2, 2, 2, 2, 2, 2, 2, 2, 2 ]
[ "•", "Multiple", "small", "nodular", "enhancement", "along", "bilateral", "ureters", "causes", "bilateral", "hydronephrosis" ]
[ 0, 1, 2, 2, 2, 2, 2, 2, 0, 1, 2 ]
[ "มา", "ตาม", "นัด", "รับ", " ", "CMT", "วันนี้", "กิน", "ไม่ค่อย", "ได้", "มี", "แน่นท้อง", "เวลา", "ทาน" ]
[ 1, 2, 2, 2, 2, 2, 0, 1, 2, 2, 1, 2, 2, 2 ]
[ "Physical", "Examination" ]
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[ "General", "appearance", ":", "Alert", ",", "good", "consciousness", ",", "not", "pale", ",", "no", "jaundice" ]
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[ "Skin", ":", "Normal" ]
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[ "Head", ":", "Normal" ]
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[ "Eye", "ENT", ":", "Normal" ]
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[ "Neck", ":", "Normal" ]
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[ "Heart", ":", "Normal" ]
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[ "Lung", ":", "Normal" ]
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[ "Abdomen", ":", "old", "midline", "surgical", "scar" ]
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[ "Nervous", "system", ":", "Normal" ]
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[ "Extremities", ":", "Normal" ]
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[ "Lymph", "nodes", ":", "Normal" ]
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[ "Genitalia", ":", "Normal" ]
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[ "Rectal", ":", "Normal" ]
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[ "Known", "case", "CA", "ascending", "colon", "with", "liver", "metastasis", "S/P", "Sx", "and", "CMT", ";", "FOLFOX", "x", "12", "cycles", "+", "RFA", "at", "Liver", "metastasis", "ปี", "2555" ]
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[ "Patho", ":", "Moderately", "differentiated", "adenocarcinoma" ]
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[ "F/U", "no", "bowel", "habit", "changes", ",", "no", "bloody", "diarrhea/", "hematochezia", ",", "no", "significant", "weight", "loss" ]
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[ "Last", "colonoscopy", "ปี", "2561", "no", "significant", "lesion" ]
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[ "F/U", "ที่", "รพ.", "เอกชน", "MRI", "upper", "abdomen", "ล่าสุด", "8/6/63", "->", "Multiple", "peritoneal", "nodules", "0.5-3.5", "cm", "มา", "ปรึกษา", " ", "GI", " ", "รพ." ]
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[ "EGD", "findings", "(23/6/63)", ":", "Diffused", "mild", "gastropathy" ]
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[ "Colono", "findings", "(23/6/63)", ":", "No", "evidence", "of", "recurrent", "tumor" ]
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[ "ทาง", "GI", "consult", "Onco", "->", "work", "up", "serum", "KRAS", ",", "NRAS", ",", "BRAF", "mutation", "negative", "all" ]
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[ "มา", "ตาม", "นัด", " ", "for", " ", "CMT", ",", "อาการ", "ปกติ", "ดี", "ไม่", "มีไข้", "ทาน", "ได้", "ปกติ" ]
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[ "Skin", ":", "Normal" ]
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[ "Head", ":", "Normal" ]
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[ "Eye", "ENT", ":", "Normal" ]
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[ "Neck", ":", "Normal" ]
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[ "Heart", ":", "Normal" ]
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[ "Lung", ":", "Normal" ]
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[ "Abdomen", ":", "Old", "midline", "surgical", "scar", ",", "soft", ",", "not", "tender", ",", "no", "palpable", "mass" ]
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[ "Nervous", "system", ":", "Normal" ]
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[ "Extremities", ":", "Normal" ]
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[ "Lymph", "nodes", ":", "Normal" ]
[ 1, 2, 0, 1 ]
[ "Genitalia", ":", "Normal" ]
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[ "Rectal", ":", "Normal" ]
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[ "Comorbidities" ]
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[ "•", "DLP", "on", "simvastatin", "(20)", "1x1", "po", "pc", "เย็น", ",", "F", "/U", " ", "ต่อเนื่อง", " ", "รพ." ]
[ 0, 1, 0, 1, 0, 0, 0, 0, 0, 0, 1, 2, 2, 2, 2, 2 ]
[ "•", "Anemia", "Dx", "กพ", ".63", "Hct", "35%", "MCV", "normal", "(", "จาก", "เดิม", "38-39%)", "ยัง", "ไม่", "ได้", " ", "work", " ", "up", " ", "เพิ่มเติม", "เนื่องจาก", "ติด", "covid-19", "ผู้ป่วย", "ได้", "iron", "and", "folic", "supplement" ]
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[ "2", "เดือนก่อน", "มา", "รพ.", "ญาติ", "สังเกตว่า", "ผอม", "ลง", "กิน", "ได้", "น้อยลง", "น้ำหนัก", "ลด", "6", "กก.", "ใน", "2", "เดือน", "(49->43", "กก.", "),", "no", "fever", "and", "cough" ]
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[ "no", "overt", "bleeding", ",", "no", "petechiae/ecchymosis", ",", "no", "sweating", ",", "no", "dysphagia", ",", "no", "epigastrium", "pain" ]
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[ "1", "เดือนก่อน", "มา", "รพ.", "ไป", "ตรวจ", "ที่", "รพ.", "เอกชน", "พบ", "Anemia", "มากขึ้น", ",", "Hct", "26%", "->", "นัด", "EGD", "+", "Colono", "work", "up", "เรื่อง", "anemia" ]
[ 0, 0, 0, 0, 0, 0, 0, 0, 0, 0, 1, 0, 0, 1, 0, 0, 0, 1, 0, 1, 1, 2, 0, 1 ]
[ "EGD", "findings", "(1/6/63)", ":", "Hemicircumferential", "ulcerative", "mass", "along", "lesser", "curvature", "from", "cardia", "to", "body", "of", "stomach" ]
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[ "Colono", "findings", "(1/6/63)", ":", "Internal", "and", "external", "hemorrhoids" ]
[ 1, 0, 0, 0, 1, 2, 2, 2 ]
[ "Patho", ":", "Poorly", "differentiated", "adenocarcinoma", "with", "signet", "ring", "cell", "features", "associated", "with", "H.pylori", "infection" ]
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[ "CT", "whole", "abdomen", "(5/6/63)" ]
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[ "•", "Infiltrative", "mass", "along", "lesser", "curvature", "with", "obliterated", "and", "irregular", "outer", "layer", "of", "stomach", "with", "multiple", "peri-gastric", "lymph", "nodes", "." ]
[ 0, 1, 2, 2, 2, 2, 2, 2, 2, 2, 2, 2, 2, 2, 0, 1, 2, 2, 2, 0 ]
[ "•", "Bony", "sclerosis", "at", "T12-L1", ",", "L3-L4", "vertebral", "bodies", "and", "sacrum" ]
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[ "3", "สัปดาห์", "ก่อน", "มา", "รพ.", "นำ", "ผล", "ตรวจ", "มา", "รับ", "การรักษา", "ต่อ", "ที่", "รพ.", "ศูนย์", "ส่องกล้อง", "(Sx)", "->", "นัด", "มา", "repeat", "EGD", "19/6/63" ]
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[ "EGD", "findings", "(18/6/63)", ":", "Ulceroinfiltrative", "mass", "(", "Borrmann", "type", "3", ")", "at", "lesser", "curvature", ",", "hemicircumferential", "from", "Z-line", "to", "lower", "body", "of", "stomach", ",", "circumferential", "at", "antrum", "caused", "lumen", "narrowing", ",", "but", "sparing", "lower", "part", "of", "antrum", "and", "pylorus", "." ]
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[ "Bon", "scan", "(18/6/63)", ":", "Multiple", "bony", "metastases", "(whole", "body)" ]
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[ "Staging", ":", "cT3N4M1,", "ทาง", "Sx", "consult", "OncoMed", "for", "palliative", "CMT" ]
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[ "1", "สัปดาห์", "ก่อน", "มา", "รพ.", "พบ", "Onco", "นัด", "มา", "admit", "for", "CMT", "C1", "วันนี้", "อาการ", "ปกติ", "ดี", "พอ", "กิน", "อาหาร", "ได้", "+", "กิน", "นม", "เสริม", "มี", "ปวด", "ตาม", "ร่างกาย" ]
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[ "ส่ง", "drug", "sensitivity", "==>", "sense", "Bactrim", ",", "Augmentin", ",", "Levofloxacin" ]
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[ "-" ]
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[ "-" ]
[ 0 ]
[ "Known", "case" ]
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[ "1.", "Suspected", "CA", "HOP", "with", "CBD", "obstruction", "S/P", "ERCP", "with", "plastic", "stents" ]
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[ "Present", "with", "progressive", "jaundice", "since", "9/62" ]
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[ "ไป", "ตรวจ", "ที่", "รพ." ]
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[ "LFT", "(20/9/62)", ":", "TB/DB", "18.3/14.4", "AST/ALT", "130/112", "ALP", "215" ]
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[ "U/S", "(9/62)", "suspected", "1.1", "cm", "distal", "CBDstone", "causing", "dilatation", "CBD", "and", "IHD", ",", "distended", "GB", "with", "bile", "sludge", "and", "multiple", "GS" ]
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[ "ERCP", "(1/10/62)", ":", "periampullary", "duodenal", "diverticulum", ",", "bulging", "of", "duodenal", "mucosa", "below", "ampulla", "suupected", "external", "compression" ]
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[ "CTWA", "(2/10/62)", ":", "supected", "mass", "of", "pancreatic", "head", "with", "bile", "duct", "obstruction", "จากนั้น", "ส่งตัว", "มา", "ที่", "รพ." ]
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[ "At", "รพ." ]
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[ "ERCP", "(17/10/62):", "Suspected", "malignent", "CBD", "stricture", "s/p", "Blush", "cytology", "and", "plastic", "stent", "10Fr", "x", "7", "cm", "SS", "at", "distal", "CBD", "," ]
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[ "Gallstone", ",", "Juxta-ampullary", "diverticula" ]
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[ "ผล", "brush", "cyto", ":", "atypical", "cell", "present" ]
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[ "จากนั้น", "ผู้ป่วย", "ไป", "รักษา", "ต่อ", "ที่", "รพ.", "มีปัญหา", "acute", "cholangitis", "หลายครั้ง", "S/P", "ERCP", "with", "exchange", "stents", "2", "รอบ", "(1/63", "and", "4/63)" ]
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[ "..." ]
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[ "1", "สัปดาห์", "ก่อน", "มา", "เริ่ม", "มี", "อาการ", "ตัว", "ตาเหลือง", "มากขึ้น", "ปวด", "จุก", "ท้อง", "พอ", "ๆ", "เดิม", "ไม่", "มีไข้", "ยัง", "พอ", "กิน", "ได้", "ได้", "ไป", "รับ", "การรักษา", "ที่", "รพ." ]
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[ "-", "ERCP", "24/6/63", "พบ", "small", "periampulaary", "diverticulum", "with", "proximal", "migration", "of", "plastic", "stent", "into", "CBD" ]
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[ "ไม่", "สามารถ", "pass", "wire", "ได้", "จึง", "ส่งตัว", "มา", "รพ.", "เพื่อ", "ERCP", "with", "SEM" ]
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[ "2", "day", "PTA", "ซึม", "เยอะ", "กิน", "ได้", "น้อย", "ปลุก", "ตื่น", "ยาก", "ไม่", "มีไข้", "เริ่ม", "เหนื่อย", "จึง", "มา", "รพ", "." ]
[ 0, 0, 0, 1, 2, 1, 2, 2, 1, 2, 2, 1, 2, 1, 2, 2, 2, 2, 0 ]
[ "dx", "acute", "cholangitis", "with", "septic", "shock", "with", "septic", "encephalopathy", "from", "CA", "head", "of", "pancrease", "หลัง", " ", "admit", "มี", "ฺ", "BP", " ", "drop", "load", "ไป", "1000", "ml", ">>", "BP", "stable", "จึง", "ย้าย", "มา" ]
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[ "PE", ":", "BT", "36.6", "℃,", "PR", "80/min,", "BP", "102/53", "mmHg,", "RR", "18/min" ]
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[ "Abd", ":", "mild", "distension", ",", "soft", ",", "mild", "tender", "at", "RUQ", "and", "epigastrium", ",", "palpable", "gallbladder" ]
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[ "UC", ",", "H/C", "28/6/63", "-->", "NG" ]
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[ "fu", "UC", "3/7/63", "NG" ]
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[ "u/s", "KUB", "3/7/63", "Chronic", "renal", "parenchymal", "disease", "of", "left", "kidney", "with", "relatively", "prominent", "left", "pelvocalyceal", "system", "without", "demonstrable", "cause", "of", "obstruction" ]
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[ "-", "No", "evidence", "of", "hydronephrosis", "of", "right", "kidney" ]
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[ "-", "Several", "right", "renal", "cysts" ]
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[ "หญิง", "58", "ปี", "Known", "case", "severe", "rheumatic", "MS", "s/p", "PTMC", "10", "ปีก่อน", "พบ", "stenosis", "จึง", "ทำ", "MVR", "with", "TV", "repair", "ปี", "2558", "ปัจจุบัน", "รักษา", "รพ.", "on", "Warfarin" ]
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[ "BADL", ",", "IADL", "พอ", "ทำได้", "อุ่น", "อาหาร", "เอง", "กินข้าว", "เอง", "ซักผ้า", "เอง" ]
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[ "ประวัติ", "ได้", "จาก", "ลูกสาว", "ที่อยู่", "ด้วยกัน", "2", "เดือนก่อน", "มา", "รพ.", "เชื่อถือได้", "ปานกลาง", "ผู้ป่วย", "มี", "ปัญหา", "ด้าน", "การ", "ได้ยิน", "สื่อสาร", "พอ", "ได", "้" ]
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[ "5", "mo.", "PTA", "สามี", "ที่", "อาศัย", "ด้วยกัน", "เกิด", "อุบัติเหตุ", "เสียชีวิต", "และ", "ลูกชาย", "ไป", "ทำงาน", "ต่างจังหวัด", "จึง", "อยู่", "บ้าน", "คนเดียว", "ยัง", "สามารถ", "เดิน", "ไป", "ทำงาน", "ล้างจาน", "ที่", "ร้านอาหาร", "ใกล้", "บ้าน", "ได้", "ลูกสาว", "แจ้ง", "ว่า", "พบ", "กันที่", "งานศพ", "พฤติกรรม", "ปก", "ต", "ิ" ]
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[ "2", "mo.", "PTA", "ลูกสาว", "ไป", "รับ", "ผู้ป่วย", "มา", "อยู่", "ที่", "กรุงเทพฯ", "ผู้ป่วย", "มี", "อาการ", "หวาดระแวง", "ว่า", "ผู้อื่น", "จะ", "มา", "ฆ่า", "ตนเอง", "หรือ", "ผู้อื่น", "จะ", "มา", "ขโมย", "เงิน", "(", "เป็น", "บุคคล", "ที่", "มีชีวิต", "อยู่", "จริง", ")", "ไม่", "มี", "หูแว่ว", "ไม่", "มี", "ภาพหลอน", "ไม่", "มี", "ทำร้าย", "ตนเอง", "หรือ", "ทำร้าย", "ผู้อื่น", "ไม่", "มี", "ทำลาย", "ข้าวของ", "ผู้ป่วย", "ยัง", "ทำ", "กิจวัตรประจำวัน", "ได้", "เอง", "พอ", "ๆ", "เดิม", "ลูกสาว", "สังเกต", "อาการ", "ขา", "บวม", "พอ", "เดิม", "กับ", "เมื่อ", "5", "เดือนก่อน", "นอน", "หนุน", "หมอน", "สอง", "ใบ", "อยู่", "เดิม", "ตั้งแต่", "หลัง", "ผ่าตัด", "ไม่", "ทราบ", "ว่า", "มี", "ลุก", "มา", "หอบ", "เหนื่อย", "กลางคืน", "หรือไม่", "สังเกตว่า", "ไม่", "มี", "หายใจ", "หอบ", "เหนื่อย" ]
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[ "1", "day", "PTA", "ที่", "บ้าน", "ไฟ", "ดับ", "ผู้ป่วย", "มี", "อาการ", "หวาดระแวง", "ว่า", "ลูกสาว", "จะ", "พา", "ไป", "ฆ่า", "ขัดขืน", "และ", "ตบหน้า", "ลูกสาว", "จึง", "พา", "ผู้ป่วย", "ไป", "รพ.", "ส่งตัว", "มา", "รพ.", "ไม่", "มี", "ชัก", "เกร็ง", "ไม่", "มี", "บ่น", "ปวดศีรษะ", "นำมา", "ก่อน", "ไม่", "มี", "แขนขา", "อ่อนแรง", "ไม่", "มี", "บ่น", "เจ็บ", "แน่นหน้าอก", "ไม่", "มี", "ประวัติ", "เบื่ออาหาร", "น้ำหนัก", "ลด", "ไม่", "มี", "ผื่น", "แพ้", "แสง", "ไม่", "ปวด", "ข้อ", "ไม่", "มี", "ผม", "ร่วง" ]
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[ "ผู้ป่วย", "จัด", "ยากิน", "เอง", "ญาติ", "ดู", "จาก", "ซอง", "ยา", "สันนิษฐาน", "ว่า", "ผู้ป่วย", "กิน", "ยา", "ไม่", "ครบ" ]
[ 0, 1, 2, 2, 0, 0, 0, 0, 0, 0, 0, 0, 1, 2, 2, 2 ]
[ "at", "ER", "V/S", ":", "T", "36.3C,", "P", "60/min,", "RR", "28/min,", "BP", "133/78mmHg,", "O2sat", "RA", "85%" ]
[ 0, 1, 1, 0, 1, 0, 1, 0, 1, 0, 1, 0, 1, 1, 0 ]