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T1 Age 2 13 65-year-old T2 Sex 14 19 woman T3 Clinical_event 20 29 presented E1 Clinical_event:T3 T4 Sign_symptom 71 75 pain E2 Sign_symptom:T4 T5 Biological_structure 50 70 right upper quadrant R1 MODIFY Arg1:T5 Arg2:E2 T6 Date 77 94 Three years prior E3 Date:T6 T7 Disease_disorder 151 154 BCS E4 Disease_disorder:T7 #1 AnnotatorNotes E4 Budd-Chiari syndrome T8 Detailed_description 140 150 idiopathic R2 MODIFY Arg1:T8 Arg2:E4 T9 Clinical_event 169 176 checkup E5 Clinical_event:T9 T10 Diagnostic_procedure 186 196 ultrasound E6 Diagnostic_procedure:T10 T11 Detailed_description 178 185 Doppler R3 MODIFY Arg1:T11 Arg2:E6 T12 Diagnostic_procedure 198 200 US E7 Diagnostic_procedure:T12 R4 IDENTICAL Arg1:E7 Arg2:E6 T13 Sign_symptom 221 232 obstruction E8 Sign_symptom:T13 T14 Biological_structure 240 269 middle and left hepatic veins R5 MODIFY Arg1:T14 Arg2:E8 T15 Disease_disorder 305 318 thrombophilia E9 Disease_disorder:T15 A1 POLARITY E9 UNCERTAIN T16 Medication 359 367 warfarin E10 Medication:T16 T17 Diagnostic_procedure 383 413 international normalized ratio E11 Diagnostic_procedure:T17 T18 Lab_value 414 429 between 2 and 3 E12 Lab_value:T18 R6 MODIFY Arg1:E12 Arg2:E11 T19 Clinical_event 513 520 consult E13 Clinical_event:T19 A2 POLARITY E13 NEG T20 Duration 542 549 2 years E14 Duration:T20 T21 Date 448 469 after at least 1 year E15 Date:T21 T22 Detailed_description 477 491 non-compliance R7 MODIFY Arg1:T22 Arg2:E10 T23 Other_event 435 447 discontinued E16 Other_event:T23 #2 AnnotatorNotes E16 discontinued warfarin T24 Sign_symptom 568 580 asymptomatic E17 Sign_symptom:T24 T25 Duration 589 601 past 3 years E18 Duration:T25 T26 Sign_symptom 675 679 pain E19 Sign_symptom:T26 T27 Frequency 662 674 intermittent T28 Detailed_description 651 660 worsening R8 MODIFY Arg1:T28 Arg2:E19 R9 MODIFY Arg1:T27 Arg2:E19 T29 Biological_structure 687 707 right upper quadrant R10 MODIFY Arg1:T29 Arg2:E19 T30 Diagnostic_procedure 767 787 Physical examination E20 Diagnostic_procedure:T30 T31 Sign_symptom 835 845 tenderness E21 Sign_symptom:T31 T32 Biological_structure 814 834 right upper quadrant R11 MODIFY Arg1:T32 Arg2:E21 T33 Sign_symptom 3262 3274 asymptomatic E22 Sign_symptom:T33 T34 Duration 3281 3287 1 year E23 Duration:T34 T35 Clinical_event 3291 3300 follow-up E24 Clinical_event:T35 T36 Medication 3240 3248 warfarin E25 Medication:T36 T37 Clinical_event 3216 3226 discharged E26 Clinical_event:T37 T38 Diagnostic_procedure 847 863 Laboratory tests E27 Diagnostic_procedure:T38 T39 Lab_value 873 888 mildly elevated E28 Lab_value:T39 T40 Diagnostic_procedure 889 898 bilirubin E29 Diagnostic_procedure:T40 T41 Lab_value 900 909 2.2 mg/dL E30 Lab_value:T41 T42 Diagnostic_procedure 915 922 albumin E31 Diagnostic_procedure:T42 T43 Lab_value 923 930 deficit E32 Lab_value:T43 T44 Lab_value 932 941 2.38 g/dL E33 Lab_value:T44 R12 MODIFY Arg1:E32 Arg2:E31 R13 MODIFY Arg1:E33 Arg2:E31 R14 MODIFY Arg1:E30 Arg2:E29 R15 MODIFY Arg1:E28 Arg2:E29 T45 Diagnostic_procedure 948 958 Child-Pugh E34 Diagnostic_procedure:T45 T46 Diagnostic_procedure 960 962 CP E35 Diagnostic_procedure:T46 R16 IDENTICAL Arg1:E35 Arg2:E34 T47 Lab_value 974 975 8 E36 Lab_value:T47 R17 MODIFY Arg1:E36 Arg2:E34 T48 Diagnostic_procedure 977 1010 Model for End-Stage Liver Disease E37 Diagnostic_procedure:T48 T49 Diagnostic_procedure 1012 1016 MELD E38 Diagnostic_procedure:T49 R18 IDENTICAL Arg1:E38 Arg2:E37 T50 Lab_value 1028 1030 11 E39 Lab_value:T50 R19 MODIFY Arg1:E39 Arg2:E37 T51 Diagnostic_procedure 1032 1041 Rotterdam E40 Diagnostic_procedure:T51 T52 Lab_value 1052 1056 0.15 E41 Lab_value:T52 R20 MODIFY Arg1:E41 Arg2:E40 T53 Diagnostic_procedure 1062 1087 BCS-TIPS prognostic index E42 Diagnostic_procedure:T53 T54 Diagnostic_procedure 1089 1100 BCS-TIPS PI E43 Diagnostic_procedure:T54 R21 IDENTICAL Arg1:E43 Arg2:E42 T55 Lab_value 1112 1115 6.3 E44 Lab_value:T55 R22 MODIFY Arg1:E44 Arg2:E42 T56 Diagnostic_procedure 1137 1156 computed tomography E45 Diagnostic_procedure:T56 T57 Detailed_description 1119 1136 contrast-enhanced R23 MODIFY Arg1:T57 Arg2:E45 T58 Diagnostic_procedure 1158 1160 CT E46 Diagnostic_procedure:T58 R24 IDENTICAL Arg1:E46 Arg2:E45 T59 Sign_symptom 1220 1232 hepatomegaly E47 Sign_symptom:T59 T60 Sign_symptom 1238 1249 hypertrophy E48 Sign_symptom:T60 T61 Diagnostic_procedure 3314 3330 laboratory tests E49 Diagnostic_procedure:T61 T62 Medication 2296 2314 conscious sedation E50 Medication:T62 T63 Diagnostic_procedure 3127 3136 recovered E51 Diagnostic_procedure:T63 T64 Lab_value 3137 3149 uneventfully E52 Lab_value:T64 T65 Sign_symptom 3195 3199 pain E53 Sign_symptom:T65 A3 POLARITY E53 NEG T66 Biological_structure 3185 3194 abdominal R25 MODIFY Arg1:T66 Arg2:E53 T67 Date 3203 3206 2 d E54 Date:T67 R26 MODIFY Arg1:E52 Arg2:E51 T68 Diagnostic_procedure 3347 3361 liver function E55 Diagnostic_procedure:T68 T69 Lab_value 3340 3346 normal E56 Lab_value:T69 R27 MODIFY Arg1:E56 Arg2:E55 T70 Diagnostic_procedure 3375 3377 US E57 Diagnostic_procedure:T70 T71 Detailed_description 3367 3374 Doppler R28 MODIFY Arg1:T71 Arg2:E57 T72 Date 3403 3435 1, 3, 6, and 12 mo postprocedure E58 Date:T72 T73 Sign_symptom 3448 3460 patent shunt E59 Sign_symptom:T73 T74 Diagnostic_procedure 3466 3468 CP E60 Diagnostic_procedure:T74 T75 Diagnostic_procedure 3482 3486 MELD E61 Diagnostic_procedure:T75 T76 Diagnostic_procedure 3500 3509 Rotterdam E62 Diagnostic_procedure:T76 T77 Diagnostic_procedure 3530 3541 TIPS-BCS PI E63 Diagnostic_procedure:T77 T78 Lab_value 3479 3480 5 E64 Lab_value:T78 T79 Lab_value 3497 3498 8 E65 Lab_value:T79 T80 Lab_value 3520 3524 0.12 E66 Lab_value:T80 T81 Lab_value 3552 3555 6.1 E67 Lab_value:T81 R29 MODIFY Arg1:E64 Arg2:E60 R30 MODIFY Arg1:E65 Arg2:E61 R31 MODIFY Arg1:E66 Arg2:E62 R32 MODIFY Arg1:E67 Arg2:E63 T82 Diagnostic_procedure 3557 3559 CT E68 Diagnostic_procedure:T82 T83 History 1526 1556 no preceding history of trauma T84 Clinical_event 2198 2205 brought E69 Clinical_event:T84 T85 Nonbiological_location 2213 2243 interventional radiology suite R33 MODIFY Arg1:T85 Arg2:E69 T86 Therapeutic_procedure 2316 2334 Portal vein access E70 Therapeutic_procedure:T86 T87 Date 1621 1639 3 years previously E71 Date:T87 T88 Sign_symptom 1174 1188 non-visualized E72 Sign_symptom:T88 T89 Biological_structure 1189 1218 middle and left hepatic veins R34 MODIFY Arg1:T89 Arg2:E72 T90 Diagnostic_procedure 3039 3070 portosystemic pressure gradient E73 Diagnostic_procedure:T90 T91 Diagnostic_procedure 3072 3075 PPG E74 Diagnostic_procedure:T91 R35 IDENTICAL Arg1:E74 Arg2:E73 T92 Lab_value 3081 3090 decreased E75 Lab_value:T92 T93 Lab_value 3096 3103 19 mmHg E76 Lab_value:T93 T94 Lab_value 3107 3113 8 mmHg E77 Lab_value:T94 R36 MODIFY Arg1:E75 Arg2:E73 R37 MODIFY Arg1:E76 Arg2:E73 R38 MODIFY Arg1:E77 Arg2:E73 A4 TREND E19 INC T95 Sign_symptom 732 765 associated or alleviating factors E78 Sign_symptom:T95 A5 POLARITY E78 NEG T96 Biological_structure 1257 1269 caudate lobe T97 Sign_symptom 1271 1283 splenomegaly E79 Sign_symptom:T97 T98 Sign_symptom 1293 1311 venous collaterals E80 Sign_symptom:T98 T99 Biological_structure 1285 1292 hepatic R39 MODIFY Arg1:T99 Arg2:E80 T100 Sign_symptom 1328 1336 aneurysm E81 Sign_symptom:T100 T101 Detailed_description 1319 1327 saccular R40 MODIFY Arg1:T101 Arg2:E81 T102 Biological_structure 1352 1388 extrahepatic portal vein main branch T103 Distance 1399 1415 3.2 cm in height T104 Area 1420 1447 2.5 cm × 2.4 cm in diameter R41 MODIFY Arg1:T102 Arg2:E81 R42 MODIFY Arg1:T103 Arg2:E81 R43 MODIFY Arg1:T104 Arg2:E81 T105 Sign_symptom 1466 1474 aneurysm E82 Sign_symptom:T105 T106 Disease_disorder 1509 1512 BCS E83 Disease_disorder:T106 T107 Disease_disorder 1550 1556 trauma E84 Disease_disorder:T107 A6 POLARITY E84 NEG T108 Diagnostic_procedure 1596 1598 US E85 Diagnostic_procedure:T108 T109 Detailed_description 1588 1595 Doppler R44 MODIFY Arg1:T109 Arg2:E85 T110 Sign_symptom 1669 1676 ascites E86 Sign_symptom:T110 A7 POLARITY E86 NEG T111 Sign_symptom 1689 1697 bleeding E87 Sign_symptom:T111 A8 POLARITY E87 NEG T112 Biological_structure 1680 1688 variceal R45 MODIFY Arg1:T112 Arg2:E87 T113 Therapeutic_procedure 1733 1737 TIPS E88 Therapeutic_procedure:T113 #3 AnnotatorNotes E88 Transjugular intrahepatic portosystemic shunt T114 Sign_symptom 1772 1783 obstruction E89 Sign_symptom:T114 T115 Biological_structure 1749 1763 hepatic venous R46 MODIFY Arg1:T115 Arg2:E89 T116 Detailed_description 1764 1771 outflow R47 MODIFY Arg1:T116 Arg2:E89 T117 Sign_symptom 1806 1810 pain E90 Sign_symptom:T117 A9 TREND E90 INC T118 Disease_disorder 1827 1840 complications E91 Disease_disorder:T118 A10 POLARITY E91 MAYBE_POS T119 Sign_symptom 1848 1856 aneurysm E92 Sign_symptom:T119 T120 Sign_symptom 1886 1894 aneurysm E93 Sign_symptom:T120 T121 Therapeutic_procedure 1863 1878 direct approach E94 Therapeutic_procedure:T121 A11 POLARITY E94 NEG T122 Sign_symptom 1979 1991 hypertension E95 Sign_symptom:T122 T123 Biological_structure 1972 1978 portal R48 MODIFY Arg1:T123 Arg2:E95 T124 Therapeutic_procedure 1997 2011 stent-grafting E96 Therapeutic_procedure:T124 A12 POLARITY E96 UNCERTAIN T125 Sign_symptom 2103 2114 obstruction E97 Sign_symptom:T125 T126 Sign_symptom 2130 2143 thrombophilia E98 Sign_symptom:T126 T127 Biological_structure 2080 2094 hepatic venous T128 Detailed_description 2095 2102 outflow R49 MODIFY Arg1:T128 Arg2:E97 R50 MODIFY Arg1:T127 Arg2:E97 T129 Diagnostic_procedure 2381 2392 fluoroscopy E99 Diagnostic_procedure:T129 T130 Diagnostic_procedure 2398 2409 portography E100 Diagnostic_procedure:T130 T131 Biological_structure 2356 2374 right hepatic vein R51 MODIFY Arg1:T131 Arg2:E70 T132 Sign_symptom 2428 2436 aneurysm E101 Sign_symptom:T132 T133 Detailed_description 2419 2427 saccular R52 MODIFY Arg1:T133 Arg2:E101 T134 Biological_structure 2452 2468 main portal vein R53 MODIFY Arg1:T134 Arg2:E101 T135 Sign_symptom 2505 2515 thrombosis E102 Sign_symptom:T135 T136 Biological_structure 2480 2504 intrahepatic portal vein R54 MODIFY Arg1:T136 Arg2:E102 T137 Severity 2470 2479 extensive R55 MODIFY Arg1:T137 Arg2:E102 T138 Sign_symptom 2539 2546 varices E103 Sign_symptom:T138 T139 Biological_structure 2527 2538 splenorenal T140 Severity 2521 2526 small R56 MODIFY Arg1:T139 Arg2:E103 R57 MODIFY Arg1:T140 Arg2:E103 T141 Therapeutic_procedure 2627 2638 stent-graft E104 Therapeutic_procedure:T141 T142 Detailed_description 2587 2610 polytetrafluoroethylene T143 Detailed_description 2612 2617 ePTFE R58 IDENTICAL Arg1:T143 Arg2:T142 R59 MODIFY Arg1:T142 Arg2:E104 T144 Detailed_description 2619 2626 covered R60 MODIFY Arg1:T144 Arg2:E104 T145 Detailed_description 2578 2586 expanded T146 Detailed_description 2563 2577 10-mm diameter R61 MODIFY Arg1:T145 Arg2:E104 R62 MODIFY Arg1:T146 Arg2:E104 T147 Detailed_description 2640 2652 Fluency Plus T148 Detailed_description 2654 2709 Bard Peripheral Vascular, Tempe, Arizona, United States R63 MODIFY Arg1:T147 Arg2:E104 R64 MODIFY Arg1:T148 Arg2:E104 T149 Biological_structure 2735 2758 liver parenchymal tract R65 MODIFY Arg1:T149 Arg2:E104 T150 Therapeutic_procedure 2774 2785 stent-graft E105 Therapeutic_procedure:T150 T151 Biological_structure 2795 2817 main portal vein trunk R66 MODIFY Arg1:T151 Arg2:E105 T152 Sign_symptom 2831 2839 aneurysm E106 Sign_symptom:T152 A13 POLARITY E105 NEG T153 Sign_symptom 2881 2889 obstruct E107 Sign_symptom:T153 A14 POLARITY E107 NEG T154 Biological_structure 2908 2928 portal vein branches R67 MODIFY Arg1:T154 Arg2:E107 T155 Diagnostic_procedure 2941 2952 portography E108 Diagnostic_procedure:T155 T156 Sign_symptom 3005 3013 aneurysm E109 Sign_symptom:T156 A15 TREND E109 DEC T159 Sign_symptom 3582 3590 aneurysm E111 Sign_symptom:T159 A16 TREND E111 DEC T160 Distance 3616 3632 2.4 cm in height T161 Area 3637 3664 2.0 cm × 1.9 cm in diameter R69 MODIFY Arg1:T160 Arg2:E111 R70 MODIFY Arg1:T161 Arg2:E111 T162 Date 3668 3678 3 mo after E112 Date:T162 T163 Therapeutic_procedure 3679 3683 TIPS E113 Therapeutic_procedure:T163 T164 Distance 3726 3742 1.9 cm in height T165 Area 3747 3774 1.6 cm × 1.5 cm in diameter T166 Date 3778 3784 1 year E114 Date:T166 R71 MODIFY Arg1:T164 Arg2:E111 R72 MODIFY Arg1:T165 Arg2:E111 * OVERLAP E1 E2 R73 AFTER Arg1:E2 Arg2:E3 * OVERLAP E3 E4 E5 E6 E8 E9 E10 E11 R74 BEFORE Arg1:E11 Arg2:E16 * OVERLAP E16 E15 R75 BEFORE Arg1:E15 Arg2:E13 * OVERLAP E13 E14 R76 BEFORE Arg1:E14 Arg2:E17 * OVERLAP E17 E18 R77 BEFORE Arg1:E18 Arg2:E19 * OVERLAP E19 E78 E20 E21 E27 E34 E37 E40 E42 E45 E72 E47 E48 E79 E80 E81 E82 E83 R78 SUB_PROCEDURE Arg1:E29 Arg2:E27 R79 SUB_PROCEDURE Arg1:E31 Arg2:E27 R80 MODIFY Arg1:T96 Arg2:E48 R81 AFTER Arg1:E83 Arg2:E84 * OVERLAP E84 E85 E71 R82 BEFORE Arg1:E71 Arg2:E86 * OVERLAP E86 E87 E88 E89 E90 E91 E92 E94 E95 E96 E97 E98 E69 E50 E70 E99 E100 E101 E102 E103 E104 E105 E106 E107 #4 AnnotatorNotes E96 this was not considered but was later performed anyway R83 BEFORE Arg1:E107 Arg2:E108 R84 BEFORE Arg1:E73 Arg2:E51 R85 BEFORE Arg1:E51 Arg2:E53 * OVERLAP E53 E54 R86 BEFORE Arg1:E54 Arg2:E26 * OVERLAP E26 E25 R87 BEFORE Arg1:E25 Arg2:E22 * OVERLAP E22 E23 E24 E49 E55 E57 E58 E59 E60 E61 E62 E63 E68 E111 T157 Sign_symptom 2969 2981 patent shunt E110 Sign_symptom:T157 * OVERLAP E108 E110 E109 E73 R68 AFTER Arg1:E111 Arg2:E112 * OVERLAP E112 E113 R88 BEFORE Arg1:E113 Arg2:E114