Forrest 4-15

ACCURACY:

OPERATIVE REPORT

PATIENT NAME: Herman Yougo

HOSPITAL NO.: 9256443

PHYSICIAN: Bryan Sego, MD

DATE: 0.5 COMMISSION October 25, _____

SURGEON: Byron Sego, MD

INDICATIONS
Metastatic squamous cell carcinoma to the neck, rule out lung primary.

FINDINGS
I could find nothing to suggest a bronchogenic carcinoma. There was a great deal of erythema and some swelling of the 1.5 INCORRECT ENGLISH MAJORmucosa in the right upper lobe, so this was biopsied. It does not look like gross 1.5 INCORRECT ENGLISH MAJORtumor, however.

PROCEDURE
Flexible bronchoscopy with forceps biopsy.

PREOPERATIVE MEDICATION
Atropine 3.0 INCORRECT MEDICAL TERM0.4 mg IM.

ANESTHESIA
Versed 3.0 INCORRECT MEDICAL TERM1.5 mg IV and Demerol 50 mg IV, topical lidocaine.

PROCEDURE IN DETAIL
After adequate preparation of the nose and posterior pharynx, 3.0 INCORRECT MEDICAL TERMthe fiberscope was introduced 0.5 WRONG ARTICLES/PREPOSITIONSwithout difficulty in the vocal cord area. Both cords moved 1.5 INCORRECT ENGLISH MAJORnormally with phonation and were free of lesions. The trachea and the main carina were 0.5 INCORRECT ENGLISH MINORnormal except there were some scattered thick secretions that almost stopped up the scope. 1.5 INCORRECT ENGLISH MAJOR These were finally suctioned free. 1.5 INCORRECT ENGLISH MAJOR There appeared to be some modest 1.5 INCORRECT ENGLISH MAJORblunting of the main carina. I examined both the left and the right tracheobronchial trees, and I could 0.5 INCORRECT ENGLISH MINORfind nothing specific in any airway to suggest a neoplasm. 3.0 INCORRECT MEDICAL TERM The only abnormality was in the right upper lobe where the mucosal surface 1.5 INCORRECT ENGLISH MAJORwas erythematous and the carina of the upper lobe somewhat blunted. I biopsied several areas here and also took bronchial washings from the area. There were no other suspicious areas, and no other bronchial washings were collected. The patient tolerated the procedure well and had the Versed reversed with Romazicon 3.0 INCORRECT MEDICAL TERMprior to transfer to his room.