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T1 Age 2 13 57-year-old T2 Sex 14 18 male T3 Clinical_event 23 31 admitted E1 Clinical_event:T3 T4 Nonbiological_location 39 47 hospital T5 Duration 53 61 5 months E2 Duration:T5 T6 Sign_symptom 89 97 bleeding E3 Sign_symptom:T6 T7 Biological_structure 82 88 rectal R1 MODIFY Arg1:T7 Arg2:E3 T8 Severity 74 81 massive R2 MODIFY Arg1:T8 Arg2:E3 T9 Duration 178 191 last 55 years E4 Duration:T9 T10 History 121 192 past history of passage of fresh blood mixed stool since last 55 years. T11 History 53 112 5 months’ history of massive rectal bleeding (rectorrhagia) T12 Sign_symptom 137 171 passage of fresh blood mixed stool E5 Sign_symptom:T12 T13 History 216 247 rectal bleeding at the age of 2 T14 Sign_symptom 223 231 bleeding E6 Sign_symptom:T14 T15 Date 239 247 age of 2 E7 Date:T15 T16 Biological_structure 216 222 rectal R3 MODIFY Arg1:T16 Arg2:E6 T17 Nonbiological_location 257 265 hospital R4 MODIFY Arg1:T4 Arg2:E1 T18 Coreference 290 297 symptom E8 Coreference:T18 R5 IDENTICAL Arg1:E8 Arg2:E6 T19 Therapeutic_procedure 308 321 interventions E9 Therapeutic_procedure:T19 T20 Family_history 1330 1369 no history of similar illness in family T21 Sign_symptom 1231 1240 dizziness E10 Sign_symptom:T21 T22 Detailed_description 1244 1252 standing R6 MODIFY Arg1:T22 Arg2:E10 T23 Sign_symptom 1254 1273 shortness of breath E11 Sign_symptom:T23 T24 Sign_symptom 1279 1290 palpitation E12 Sign_symptom:T24 T25 Detailed_description 1294 1318 walking a short distance R7 MODIFY Arg1:T25 Arg2:E12 T26 Clinical_event 252 256 went E13 Clinical_event:T26 R8 MODIFY Arg1:T17 Arg2:E13 T27 History 449 485 diagnosed and treated as hemorrhoids T28 Sign_symptom 491 498 symptom E14 Sign_symptom:T28 A1 POLARITY E14 NEG T29 Duration 516 523 a while E15 Duration:T29 T30 Sign_symptom 533 541 recurred E16 Sign_symptom:T30 T31 Date 549 565 Thirty years ago E17 Date:T31 T32 Disease_disorder 594 604 hemangioma E18 Disease_disorder:T32 T33 Biological_structure 587 593 rectal R9 MODIFY Arg1:T33 Arg2:E18 T34 Therapeutic_procedure 622 633 cryotherapy E19 Therapeutic_procedure:T34 T35 Nonbiological_location 641 649 hospital R10 MODIFY Arg1:T35 Arg2:E19 T36 Duration 696 705 few years E20 Duration:T36 T37 Sign_symptom 684 691 symptom E21 Sign_symptom:T37 A2 POLARITY E21 NEG T38 Sign_symptom 713 721 recurred E22 Sign_symptom:T38 T39 Clinical_event 738 747 consulted E23 Clinical_event:T39 T40 Nonbiological_location 748 768 many other hospitals R11 MODIFY Arg1:T40 Arg2:E23 T41 Duration 858 872 Since 5 months E24 Duration:T41 T42 Sign_symptom 897 905 bleeding E25 Sign_symptom:T42 A3 TREND E25 INC T43 Biological_structure 890 896 rectal R12 MODIFY Arg1:T43 Arg2:E25 T44 Clinical_event 925 929 went E26 Clinical_event:T44 T45 Nonbiological_location 933 947 local hospital R13 MODIFY Arg1:T45 Arg2:E26 T46 Therapeutic_procedure 954 966 intervention E27 Therapeutic_procedure:T46 T47 Medication 1048 1053 fluid E28 Medication:T47 T48 Therapeutic_procedure 1058 1075 blood transfusion E29 Therapeutic_procedure:T48 T49 Administration 1036 1047 intravenous R14 MODIFY Arg1:T49 Arg2:E28 T50 Therapeutic_procedure 1000 1021 symptomatic treatment E30 Therapeutic_procedure:T50 T51 Clinical_event 1088 1096 referred E31 Clinical_event:T51 T52 Nonbiological_location 1104 1112 hospital R15 MODIFY Arg1:T52 Arg2:E31 T53 Diagnostic_procedure 1374 1393 general examination E32 Diagnostic_procedure:T53 T54 Sign_symptom 1412 1416 pale E33 Sign_symptom:T54 T55 Diagnostic_procedure 1426 1436 heart rate E34 Diagnostic_procedure:T55 T56 Diagnostic_procedure 1441 1455 blood pressure E35 Diagnostic_procedure:T56 T57 Lab_value 1461 1480 within normal limit R16 MODIFY Arg1:T57 Arg2:E35 R17 MODIFY Arg1:T57 Arg2:E34 R18 SUB_PROCEDURE Arg1:E34 Arg2:E32 R19 SUB_PROCEDURE Arg1:E35 Arg2:E32 T58 Duration 1526 1546 during last 5 months E36 Duration:T58 T59 Diagnostic_procedure 1551 1569 rectal examination E37 Diagnostic_procedure:T59 T60 Diagnostic_procedure 1514 1525 body weight E38 Diagnostic_procedure:T60 T61 Lab_value 1497 1506 lost 5 kg R20 MODIFY Arg1:T61 Arg2:E38 T62 Sign_symptom 1571 1582 fresh blood E39 Sign_symptom:T62 T63 Biological_structure 1592 1610 around anal region R21 MODIFY Arg1:T63 Arg2:E39 T64 Sign_symptom 1620 1624 mass E40 Sign_symptom:T64 T65 Texture 1615 1619 soft R22 MODIFY Arg1:T65 Arg2:E40 T66 Diagnostic_procedure 1637 1663 digital rectal examination E41 Diagnostic_procedure:T66 R23 SUB_PROCEDURE Arg1:E41 Arg2:E37 T67 Diagnostic_procedure 1668 1679 proctoscopy E42 Diagnostic_procedure:T67 T68 Biological_structure 1681 1692 anal cavity R24 MODIFY Arg1:T68 Arg2:E43 T69 Sign_symptom 1726 1737 fresh blood E43 Sign_symptom:T69 T70 Biological_structure 1697 1703 rectum R25 MODIFY Arg1:T70 Arg2:E43 T71 Sign_symptom 1743 1766 active site of bleeding E44 Sign_symptom:T71 A4 POLARITY E44 NEG T72 Sign_symptom 1768 1773 polyp E45 Sign_symptom:T72 A5 POLARITY E45 NEG T73 Sign_symptom 1778 1783 ulcer E46 Sign_symptom:T73 A6 POLARITY E46 NEG T74 Diagnostic_procedure 1805 1827 laboratory examination E47 Diagnostic_procedure:T74 T75 Diagnostic_procedure 1829 1849 red blood cell count E48 Diagnostic_procedure:T75 T76 Lab_value 1854 1867 3.09 × 1012/L R26 MODIFY Arg1:T76 Arg2:E48 T77 Diagnostic_procedure 1901 1911 hemoglobin E49 Diagnostic_procedure:T77 T78 Lab_value 1916 1922 86 g/L R27 MODIFY Arg1:T78 Arg2:E49 T79 Diagnostic_procedure 1946 1966 All other parameters E50 Diagnostic_procedure:T79 T80 Lab_value 1972 1991 within normal limit R28 MODIFY Arg1:T80 Arg2:E50 T81 Diagnostic_procedure 2007 2009 CT E51 Diagnostic_procedure:T81 T82 Detailed_description 1993 2006 None enhanced #1 AnnotatorNotes T82 non-enhanced? R29 MODIFY Arg1:T82 Arg2:E51 T83 Sign_symptom 2056 2066 thickening E52 Sign_symptom:T83 T84 Biological_structure 2045 2055 bowel wall R30 MODIFY Arg1:T84 Arg2:E52 T85 Detailed_description 2034 2044 homogenous R31 MODIFY Arg1:T85 Arg2:E52 T86 Detailed_description 2017 2025 isodense T87 Lab_value 2027 2032 35 HU R32 MODIFY Arg1:T87 Arg2:T86 R33 MODIFY Arg1:T86 Arg2:E52 T88 Diagnostic_procedure 2093 2095 CT E53 Diagnostic_procedure:T88 T89 Detailed_description 2075 2092 contrast-enhanced R34 MODIFY Arg1:T89 Arg2:E53 T90 Sign_symptom 2109 2117 enhances E54 Sign_symptom:T90 T91 Detailed_description 2096 2108 venous phase T92 Detailed_description 2118 2133 heterogeneously R35 MODIFY Arg1:T92 Arg2:E54 R36 MODIFY Arg1:T91 Arg2:E54 T93 Sign_symptom 2144 2158 calcifications E55 Sign_symptom:T93 T94 Detailed_description 2135 2143 Multiple R37 MODIFY Arg1:T94 Arg2:E55 T95 Biological_structure 2176 2196 thickened bowel wall R38 MODIFY Arg1:T95 Arg2:E55 T96 Biological_structure 2212 2228 peri-rectal area R39 MODIFY Arg1:T96 Arg2:E55 T97 Sign_symptom 2230 2236 Lesion E56 Sign_symptom:T97 T98 Biological_structure 2261 2275 distal sigmoid T99 Biological_structure 2279 2298 whole of the rectum R40 MODIFY Arg1:T98 Arg2:E56 R41 MODIFY Arg1:T99 Arg2:E56 T100 Sign_symptom 2327 2334 lesions E57 Sign_symptom:T100 T101 Detailed_description 2308 2316 Multiple T102 Detailed_description 2317 2326 hypodense R42 MODIFY Arg1:T102 Arg2:E57 R43 MODIFY Arg1:T101 Arg2:E57 T103 Biological_structure 2353 2359 spleen R44 MODIFY Arg1:T103 Arg2:E57 T104 Sign_symptom 2397 2403 anemia E58 Sign_symptom:T104 T105 Therapeutic_procedure 2437 2447 laparotomy E59 Therapeutic_procedure:T105 T106 Therapeutic_procedure 2460 2477 surgical excision E60 Therapeutic_procedure:T106 T107 Biological_structure 2427 2436 abdominal R45 MODIFY Arg1:T107 Arg2:E59 T108 Sign_symptom 2506 2512 lesion E61 Sign_symptom:T108 T109 Distance 2495 2500 25 cm R46 MODIFY Arg1:T109 Arg2:E61 T110 Therapeutic_procedure 2383 2393 management E62 Therapeutic_procedure:T110 T111 Biological_structure 2538 2552 distal sigmoid T112 Biological_structure 2556 2575 whole of the rectum R47 MODIFY Arg1:T111 Arg2:E61 R48 MODIFY Arg1:T112 Arg2:E61 T113 Therapeutic_procedure 2657 2668 anastomosis E63 Therapeutic_procedure:T113 T114 Detailed_description 2644 2656 sigmoid-anus R49 MODIFY Arg1:T114 Arg2:E63 T115 Therapeutic_procedure 2632 2639 excised E64 Therapeutic_procedure:T115 T116 Biological_structure 2601 2626 part of the sigmoid colon T117 Biological_structure 2577 2596 Whole of the rectum R50 MODIFY Arg1:T116 Arg2:E64 R51 MODIFY Arg1:T117 Arg2:E64 T118 Diagnostic_procedure 2692 2721 histopathological examination E65 Diagnostic_procedure:T118 T119 Detailed_description 2725 2741 excised specimen R52 MODIFY Arg1:T119 Arg2:E65 T120 Diagnostic_procedure 2975 2995 Immunohistochemistry E66 Diagnostic_procedure:T120 T121 Diagnostic_procedure 3046 3051 CD 31 E67 Diagnostic_procedure:T121 T122 Diagnostic_procedure 3056 3061 CD 34 E68 Diagnostic_procedure:T122 T123 Lab_value 3033 3041 positive R53 MODIFY Arg1:T123 Arg2:E67 R54 MODIFY Arg1:T123 Arg2:E68 T124 Biological_structure 3015 3032 endothelial cells R55 MODIFY Arg1:T124 Arg2:T123 R56 SUB_PROCEDURE Arg1:E67 Arg2:E66 R57 SUB_PROCEDURE Arg1:E68 Arg2:E66 T125 Diagnostic_procedure 3092 3097 D2–40 E69 Diagnostic_procedure:T125 T126 Diagnostic_procedure 3130 3135 D2–40 E70 Diagnostic_procedure:T126 R58 SUB_PROCEDURE Arg1:E69 Arg2:E66 R59 SUB_PROCEDURE Arg1:E70 Arg2:E66 T127 Biological_structure 3063 3073 Some cells T128 Biological_structure 3105 3111 others #2 AnnotatorNotes T128 other cells T129 Lab_value 3117 3125 negative T130 Lab_value 3079 3087 positive R60 MODIFY Arg1:T130 Arg2:E69 R61 MODIFY Arg1:T129 Arg2:E70 R62 MODIFY Arg1:T128 Arg2:T129 R63 MODIFY Arg1:T127 Arg2:T130 T131 Disease_disorder 3212 3228 hemolymphangioma E71 Disease_disorder:T131 T132 Disease_disorder 3300 3309 infection E72 Disease_disorder:T132 T133 Biological_structure 3289 3299 intestinal R64 MODIFY Arg1:T133 Arg2:E72 T134 Clinical_event 3349 3359 discharged E73 Clinical_event:T134 T135 Nonbiological_location 3365 3373 hospital R65 MODIFY Arg1:T135 Arg2:E73 T136 Date 3381 3389 23rd day E74 Date:T136 T137 Sign_symptom 3425 3437 complication E75 Sign_symptom:T137 A7 POLARITY E75 NEG T138 Sign_symptom 3441 3451 recurrence E76 Sign_symptom:T138 A8 POLARITY E76 NEG T139 Duration 3471 3480 6 months’ E77 Duration:T139 T140 Clinical_event 3481 3490 follow-up E78 Clinical_event:T140 T141 Detailed_description 2749 2787 submucosal multiple thin-walled vessel T142 Lab_value 2791 2803 varying size T143 Lab_value 2809 2826 interposed stroma R66 MODIFY Arg1:T141 Arg2:T119 R67 MODIFY Arg1:T142 Arg2:T141 R68 MODIFY Arg1:T143 Arg2:T141 T144 Lab_value 2828 2871 Some vessels lumen consisted of blood cells T145 Lab_value 2912 2942 other consisted of clear fluid R69 MODIFY Arg1:T144 Arg2:T141 R70 MODIFY Arg1:T145 Arg2:T141 R71 AFTER Arg1:E1 Arg2:E2 * OVERLAP E2 E3 R72 AFTER Arg1:E3 Arg2:E5 * OVERLAP E5 E4 E6 E7 R73 BEFORE Arg1:E7 Arg2:E13 * OVERLAP E13 E8 E9 R74 BEFORE Arg1:E9 Arg2:E14 * OVERLAP E14 E15 R75 BEFORE Arg1:E15 Arg2:E16 R76 BEFORE Arg1:E16 Arg2:E17 * OVERLAP E17 E18 E19 R77 BEFORE Arg1:E19 Arg2:E21 * OVERLAP E21 E20 R78 BEFORE Arg1:E20 Arg2:E22 R79 BEFORE Arg1:E22 Arg2:E23 T146 Sign_symptom 800 818 symptomatic relief E79 Sign_symptom:T146 A9 POLARITY E79 UNCERTAIN T147 Detailed_description 789 799 short-term R80 MODIFY Arg1:T147 Arg2:E79 * OVERLAP E23 E79 R81 BEFORE Arg1:E79 Arg2:E24 * OVERLAP E24 E25 R82 BEFORE Arg1:E25 Arg2:E26 * OVERLAP E26 E27 E80 E30 E28 E29 T148 Sign_symptom 987 995 bleeding E80 Sign_symptom:T148 R83 BEFORE Arg1:E29 Arg2:E31 T149 Sign_symptom 1157 1165 bleeding E81 Sign_symptom:T149 T150 Detailed_description 1169 1180 fresh blood R84 MODIFY Arg1:T150 Arg2:E81 T151 Biological_structure 1150 1156 rectal R85 MODIFY Arg1:T151 Arg2:E81 T152 Severity 1137 1149 Intermediate R86 MODIFY Arg1:T152 Arg2:E81 T153 Clinical_event 1198 1207 admission E82 Clinical_event:T153 R87 BEFORE Arg1:E31 Arg2:E81 * OVERLAP E81 E82 E10 E11 E12 E32 E33 R88 AFTER Arg1:E33 Arg2:E38 * OVERLAP E38 E36 R89 BEFORE Arg1:E36 Arg2:E37 * OVERLAP E37 E39 E40 E42 E43 E44 E45 E46 E47 E50 E51 E52 E53 E54 E55 E56 E57 R90 SUB_PROCEDURE Arg1:E48 Arg2:E47 R91 SUB_PROCEDURE Arg1:E49 Arg2:E47 R92 BEFORE Arg1:E57 Arg2:E62 * OVERLAP E62 E58 R93 BEFORE Arg1:E58 Arg2:E59 * OVERLAP E59 E60 E61 E64 E63 R94 BEFORE Arg1:E63 Arg2:E65 * OVERLAP E65 E66 E71 R95 BEFORE Arg1:E71 Arg2:E72 T154 Therapeutic_procedure 3321 3328 managed E83 Therapeutic_procedure:T154 R96 BEFORE Arg1:E72 Arg2:E83 * OVERLAP E83 E73 R97 BEFORE Arg1:E73 Arg2:E75 * OVERLAP E75 E76 E77 E78