CHIEF COMPLAINT: Transfer from [**Hospital3 **] Hospital for 10cm ruptured abdominal
aortic aneurysm.

PRESENT ILLNESS: 84 year old woman with history of hypertension who presented to
[**Hospital3 **] hospital on [**2156-11-19**] with complaint of abdominal pain,
nausea, and vomiting.  She underwent a CT of the abdomen at [**Location (un) 21541**] which demonstrated a 10cm abdominal aortic aneursym with
extravasation of contrast concerning for rupture, and she was
emergently transferred to [**Hospital1 18**] via [**Location (un) **].

MEDICAL HISTORY: Hypertension

MEDICATION ON ADMISSION: diltiazem (unknown dose)

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: DECEASED:  Absent breath sounds, no pulse.  Pupils non-reactive
and fixed.

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Lives with husband on [**Hospital3 **]; +smoker.
Abdominal aneurysm, ruptured,Acute and subacute necrosis of liver,Defibrination syndrome,Acute vascular insufficiency of intestine,Acute kidney failure with lesion of tubular necrosis,Acidosis,Unspecified essential hypertension,Tobacco use disorder
Rupt abd aortic aneurysm,Acute necrosis of liver,Defibrination syndrome,Ac vasc insuff intestine,Ac kidny fail, tubr necr,Acidosis,Hypertension NOS,Tobacco use disorder
Admission Date:  [**2156-9-19**]              Discharge Date:   [**2156-9-20**]

Date of Birth:  [**2072-7-28**]             Sex:   F

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 4748**]
Chief Complaint:
Transfer from [**Hospital3 **] Hospital for 10cm ruptured abdominal
aortic aneurysm.

Major Surgical or Invasive Procedure:
[**2156-9-19**] - open repair of abdominal aortic aneurysm

History of Present Illness:
84 year old woman with history of hypertension who presented to
[**Hospital3 **] hospital on [**2156-11-19**] with complaint of abdominal pain,
nausea, and vomiting.  She underwent a CT of the abdomen at [**Location (un) 21541**] which demonstrated a 10cm abdominal aortic aneursym with
extravasation of contrast concerning for rupture, and she was
emergently transferred to [**Hospital1 18**] via [**Location (un) **].

Past Medical History:
Hypertension

Social History:
Lives with husband on [**Hospital3 **]; +smoker.

Family History:
Noncontributory

Physical Exam:
DECEASED:  Absent breath sounds, no pulse.  Pupils non-reactive
and fixed.

Pertinent Results:
[**2156-9-20**] 05:45PM BLOOD WBC-8.5 RBC-3.25* Hgb-9.7* Hct-27.0*
MCV-83 MCH-29.8 MCHC-35.8* RDW-16.1* Plt Ct-100*
[**2156-9-20**] 05:45PM BLOOD PT-17.2* PTT-45.7* INR(PT)-1.5*
[**2156-9-20**] 05:45PM BLOOD Fibrino-132*
[**2156-9-20**] 04:23PM BLOOD Glucose-89 Na-154* K-4.6 Cl-109*
[**2156-9-20**] 04:23PM BLOOD CK(CPK)-1511*
[**2156-9-20**] 04:23PM BLOOD CK-MB-28* MB Indx-1.9 cTropnT-0.44*
[**2156-9-20**] 06:23PM BLOOD Type-ART pO2-72* pCO2-31* pH-7.27*
calTCO2-15* Base XS--11
[**2156-9-20**] 06:23PM BLOOD Glucose-52* Lactate-11.5* K-3.8

Brief Hospital Course:
Ms. [**Known lastname 39777**] was taken emergently to the operating room on [**2156-9-19**]
and underwent open repair of her ruptured abdominal aortic
aneurysm.  She received crystalloid and colloid resuscitation
intraoperatively and was taken to the CVIC in critical
condition, intubated and sedated.  Family was notified of the
critical nature of her clinical state, and she was managed over
the next 24 hours with warming blankets, aggressive fluid
resuscitation, correction of coagulopathy with blood products,
and correction of her profound metabolic acidosis with sodium
bicarbonate.  She was in multi organ system failure
postoperatively and though she was initially hemodynamically
stable, she ultimately required pressors to maintain a perfusing
blood pressure and she was anuric.  A renal ultrasound
demonstrated no flow within the renal arteries, suggesting that
the kidneys had succumbed to the aneurysm prior to or during the
surgical repair.  Additionally she began to demonstrate signs of
abdominal distention and DIC, and a general surgery consultation
was obtained to evaluate the need for exploratory laparotomy
given the concern for bowel ischemia.  A family meeting was held
and the possibilities for her care were discussed, including
return to the operating room for abdominal exploration, CVVHD,
non-operative management, and comfort measures.  The family
ultimately opted to transition to comfort care, and the patient
was made "CMO" status in the evening of [**2156-9-20**] with family
present at the bedside.  Pastoral services was present to
administer the patient her last rites.  She passed away several
hours later at 20:40.  Her husband was notified.  Initially he
expressed interest in having an autopsy performed, but later he
called back to decline the postmortem exam; this wish was
communicated to the admitting office and to the pathology
department.  The medical examiner was contact[**Name (NI) **] and declined a
postmortem exam.

Medications on Admission:
diltiazem (unknown dose)

Discharge Medications:
N/A

Discharge Disposition:
Expired

Discharge Diagnosis:
ruptured abdominal aortic aneurysm

Discharge Condition:
expired

Discharge Instructions:
N/A

Followup Instructions:
N/A
{'Abdominal aneurysm, ruptured,Acute and subacute necrosis of liver,Defibrination syndrome,Acute vascular insufficiency of intestine,Acute kidney failure with lesion of tubular necrosis,Acidosis,Unspecified essential hypertension,Tobacco use disorder'}


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: Transfer from [**Hospital3 **] Hospital for 10cm ruptured abdominal
aortic aneurysm.

PRESENT ILLNESS: 84 year old woman with history of hypertension who presented to
[**Hospital3 **] hospital on [**2156-11-19**] with complaint of abdominal pain,
nausea, and vomiting.  She underwent a CT of the abdomen at [**Location (un) 21541**] which demonstrated a 10cm abdominal aortic aneursym with
extravasation of contrast concerning for rupture, and she was
emergently transferred to [**Hospital1 18**] via [**Location (un) **].

MEDICAL HISTORY: Hypertension

MEDICATION ON ADMISSION: diltiazem (unknown dose)

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: DECEASED:  Absent breath sounds, no pulse.  Pupils non-reactive
and fixed.

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: Lives with husband on [**Hospital3 **]; +smoker. 

### Response:
{'Abdominal aneurysm, ruptured,Acute and subacute necrosis of liver,Defibrination syndrome,Acute vascular insufficiency of intestine,Acute kidney failure with lesion of tubular necrosis,Acidosis,Unspecified essential hypertension,Tobacco use disorder'}
