CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 63-year-old
female status post thoracotomy with Dr. [**Last Name (STitle) 175**] one week prior
for small cell lung carcinoma.  The patient was seen by the
doctor today.  The patient had complaints of right lower
quadrant pain times four days with fevers with nausea,
vomiting, and increasing distention.  The patient has had
diverticula on prior CT studies.  No prior colonoscopies.
Prior duodenal ulcer history treated medially.  No prior
abdominal surgeries.

MEDICAL HISTORY: 1.  Atrial fibrillation.
2.  Chronic obstructive pulmonary disease.
3.  Small cell lung carcinoma.
4.  ASD repair.
5.  Pulmonary hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies..

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Diverticulitis of colon (without mention of hemorrhage),Abscess of intestine,Appendicitis, unqualified,Malignant neoplasm of other parts of bronchus or lung,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Primary pulmonary hypertension
Dvrtcli colon w/o hmrhg,Intestinal abscess,Appendicitis NOS,Mal neo bronch/lung NEC,Atrial fibrillation,Chr airway obstruct NEC,Prim pulm hypertension
Admission Date:  [**2161-4-30**]       Discharge Date:  [**2161-5-9**]

Date of Birth:   [**2097-12-31**]       Sex:  F

Service:  GENERAL S.

HISTORY OF THE PRESENT ILLNESS:  The patient is a 63-year-old
female status post thoracotomy with Dr. [**Last Name (STitle) 175**] one week prior
for small cell lung carcinoma.  The patient was seen by the
doctor today.  The patient had complaints of right lower
quadrant pain times four days with fevers with nausea,
vomiting, and increasing distention.  The patient has had
diverticula on prior CT studies.  No prior colonoscopies.
Prior duodenal ulcer history treated medially.  No prior
abdominal surgeries.

PAST MEDICAL HISTORY:
1.  Atrial fibrillation.
2.  Chronic obstructive pulmonary disease.
3.  Small cell lung carcinoma.
4.  ASD repair.
5.  Pulmonary hypertension.

ALLERGIES:  No known drug allergies..

MEDICATIONS:
1.  Paroxetine.
2.  Sotalol.
3.  Alprazolam.
4.  Albuterol.
5.  Prednisone.
6.  Lasix,
7.  Coumadin.
8.  Protonix.
9.  Home oxygen.

The patient had a CT scan done, which showed no coronary
artery disease and ejection fraction of 60%.

PHYSICAL EXAMINATION:  On examination, the patient was
afebrile.  Vital signs were stable.  Abdomen was firm and
distended, tender at the right lower quadrant greater than
the left lower quadrant with guarding, rebound, and
percussion tenderness.  There were no hernias noted.

The patient had a white count of 15, hematocrit 36, platelet
count 310,000.  Potassium was 3.6.  Otherwise, electrolytes
were within normal limits.

CT showed positive free air, positive cecal sigmoid
diverticula.  Duodenum appeared intact with intraluminal air
and positive pelvic free fluid.

The patient was placed on Levofloxacin and Flagyl.  The
patient was made NPO.  The patient was started on IV fluids
and Foley catheter was placed.

HOSPITAL COURSE:  The patient was taken to the operating room
on [**5-1**] for a perforated viscus, sigmoid diverticulitis,
and secondary appendicitis.  Hartmann's procedure with
appendectomy was done with no complications.  The patient was
transferred to the SICU, intubated for monitoring.

On postoperative day #1, the patient was extubated.  The
patient was afebrile, vital signs were stable.  The patient
had 100% saturation on two liters nasal cannula.  White count
was done to 10.  Hematocrit was 29.  Platelet count was
305,000.  Other electrolytes were within normal limits.
Overnight, on postoperative day #1, the patient had an
episode of shortness of breath.  The patient was placed on
KVO and given Lasix.  The patient also had a brief run of
atrial fibrillation for which she was given Lopressor.

On postoperative day #3, steroids were to be weaned.  Lasix
was continued.  The patient was still on Lopressor.  White
count now was 11.3.  The patient was placed on broad-spectrum
antibiotics.

On postoperative day #5, the patient was still on Ampicillin,
Levofloxacin, and Flagyl.  The patient was afebrile.  Vital
signs were stable with the same bibasilar crackles.  Abdomen
was soft, nontender, and nondistended.  The patient had
positive tympany.  Serosanguinous fluid in ostomy bag, viable
appearing pink stoma.  White count had increased to 17.6, now
down to 13.3.

On postoperative day #6, the patient continued to be
afebrile, vital signs were stable.  The patient was still on
Ampicillin, Levofloxacin, and Flagyl.  The patient appeared
to be opening up, started on PO pain medications.

The patient's white count was noted to be 18.3.  Abdominal CT
was performed to rule out any leak or abscess.  CT was
negative.

On postoperative day #7, the INR was found to be
supratherapeutic at 14.5.  Vitamin K was given.  IV:  The
patient continued to be afebrile, vital signs were stable.
White count now decreased to 12.9.  The INR was now down to
1.4.  The patient with gas in ostomy.  The patient continued
to advance with diet, holding the Coumadin.  Antibiotics were
discontinued.

On postoperative day #8, the patient had no complaints.  The
patient was afebrile.  Vital signs were stable.  Abdomen was
soft, nontender, and nondistended.  White count was now at
12.8.  The patient was felt to be tolerating a good diet and
pain was controlled.  The patient was ambulating freely.  The
patient was stable for discharge to home with VNA services.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  The patient was discharged to home with
VNA.

FINAL DIAGNOSIS:
1.  Status post Hartmann's procedure.
2.  Appendectomy.
3.  Chronic obstructive pulmonary disease.
4.  Small cell lung carcinoma.
5.  Pulmonary hypertension.
6.  Atrial fibrillation.

DISCHARGE MEDICATIONS:
1.  Percocet for pain control.
2.  Prednisone 30 mg q.d.

The patient is to be restarted on all previous medications.
The patient is to follow up with Dr. [**Last Name (STitle) **].




                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3799**], M.D.  [**MD Number(1) 3800**]

Dictated By:[**Last Name (NamePattern4) 20704**]
MEDQUIST36

D:  [**2161-8-13**]  10:05
T:  [**2161-8-13**]  10:15
JOB#:  [**Job Number 20705**]
{'Diverticulitis of colon (without mention of hemorrhage),Abscess of intestine,Appendicitis, unqualified,Malignant neoplasm of other parts of bronchus or lung,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Primary pulmonary hypertension'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 63-year-old
female status post thoracotomy with Dr. [**Last Name (STitle) 175**] one week prior
for small cell lung carcinoma.  The patient was seen by the
doctor today.  The patient had complaints of right lower
quadrant pain times four days with fevers with nausea,
vomiting, and increasing distention.  The patient has had
diverticula on prior CT studies.  No prior colonoscopies.
Prior duodenal ulcer history treated medially.  No prior
abdominal surgeries.

MEDICAL HISTORY: 1.  Atrial fibrillation.
2.  Chronic obstructive pulmonary disease.
3.  Small cell lung carcinoma.
4.  ASD repair.
5.  Pulmonary hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies..

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Diverticulitis of colon (without mention of hemorrhage),Abscess of intestine,Appendicitis, unqualified,Malignant neoplasm of other parts of bronchus or lung,Atrial fibrillation,Chronic airway obstruction, not elsewhere classified,Primary pulmonary hypertension'}
