BobLarson: Yes, it is truncated.
What I see in Access:
convexity stroke. Brainstem reflexes are present. Prognosis not good in terms of functional recovery.
In SS (i highlighted what was not truncated in Access):
(Related Case #2912) 71 year-old female with a history of multiple strokes, rectal cancer , s/p low anterior resection 2009 and total colectomy with ileostomy 2009. She presented with persistent rectal bleeding from the rectal stump. In 4/11/2012 a completion proctectomy with abdomino-perineal approach, hysterectomy, left oophorectomy, repair of enterotomy, and repair of ventral hernia was done. A second surgeon was called in to assist when an open laparotomy approach became necessary. Pre-op Labs: WBC 6.3, Hgb 13.2/Hct 39.1; Plts 217, During procedure the last 2 hours the patient did not have any urine output and was given a 1 L fluid bolus EBL was 1000cc Upon completion of the procedure the patient developed hypotension and PEA that required fluid resuscitation and some chest compressions. A large amount of blood was coming from the pelvic drain. The abdominal incision was reopened and a large amount of blood was in the abdomen and pelvis. Findings: There was diffuse oozing from all sites including the wound and from the ileum consistent with severe coagulopathic bleeding.. Primarily venous bleeding from the pelvic floor and side wall. Multiple other sites of hemorrhage that were difficult to control locally. Due to the developing coagulopathy ( PT 46.1, INR 5.1, PTT 61 and Plts 50,000)and long period of hypothermia the pelvis was tightly packed and a temporary abdominal closure was done. Total EBL 3600 cc /700cc urine output. Patient responded to multiple blood products: 13 units PRBCs; 1000cc FFP; 500 cc Plts, plus fluids. 4/13/2012 a repeat laparotomy with removal of the packing and control of hemorrhage was performed. The patient remained intubated and sedated in the CTICU. 4/16/ Off sedation 12 hours and remains unresponsive could be persistent Fentanyl effect Neurology consulted; grimaces on vent does not follow commands 4/17 Neurology Impression 72 hours post-op : Anoxic encephalopathy decompensation with underlying multi0infarct state and questionable new left hemispheric convexity stroke. Brainstem reflexes are present. Prognosis not good in terms of functional recovery. Tube feedings started Family initially wanted aggressive care , then decided against trach and ventilator was withdrawn and patient expired 4/16/2012.