CHIEF COMPLAINT: 

PRESENT ILLNESS: Mr. [**Known lastname 22371**] is a 75-year-old male
admitted electively on [**1-9**] for an exploratory laparoscopy to
evaluate a gallbladder mass he is known to have.  He had
presented earlier in the year with obstructive jaundice and a
He was initially evaluated and cared for by Dr. [**Last Name (STitle) **].  He
had significant hemobilia at that time which was proven by
ERCP.  He was stabilized once and an embolization procedure
of the right hepatic arterial branch pseudoaneurysm was
performed.  His liver function tests improved and he was
discharged home.  He returned on the 6th for this admission
for a procedure to do an exploratory laparoscopy to evaluate
complaints.

MEDICAL HISTORY: Significant for diabetes and
hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: He is married with one daughter active in
his care.  Rare alcohol, denies tobacco.
Malignant neoplasm of gallbladder,Atrial fibrillation,Hematemesis,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension
Malig neo gallbladder,Atrial fibrillation,Hematemesis,DMII wo cmp nt st uncntr,Hypertension NOS
Admission Date:  [**2193-1-9**]     Discharge Date:  [**2193-1-17**]

Date of Birth:   [**2118-1-11**]     Sex:  M


HISTORY OF PRESENT ILLNESS:  Mr. [**Known lastname 22371**] is a 75-year-old male
admitted electively on [**1-9**] for an exploratory laparoscopy to
evaluate a gallbladder mass he is known to have.  He had
presented earlier in the year with obstructive jaundice and a
He was initially evaluated and cared for by Dr. [**Last Name (STitle) **].  He
had significant hemobilia at that time which was proven by
ERCP.  He was stabilized once and an embolization procedure
of the right hepatic arterial branch pseudoaneurysm was
performed.  His liver function tests improved and he was
discharged home.  He returned on the 6th for this admission
for a procedure to do an exploratory laparoscopy to evaluate
complaints.

PAST MEDICAL HISTORY:  Significant for diabetes and
hypertension.

ALLERGIES:  No known drug allergies.

SOCIAL HISTORY:  He is married with one daughter active in
his care.  Rare alcohol, denies tobacco.

MEDICATIONS:  At home were Norvasc, Lisinopril, Atenolol,
Glyburide, Pantoprazole, Doxepin and Lasix.

HOSPITAL COURSE:  The patient was initially admitted to the
surgical service where he underwent a laparoscopy on the 6th.
A biopsy was taken of the mass which later revealed
gallbladder adenocarcinoma.  He additionally was found to
have a mucopurulent gallbladder wall.  Cholecystectomy was
not performed at the time.  He was started on empiric
Levaquin.  Postoperative day #1 the patient was actually
planned to be discharged home on empiric antibiotics but he
developed a new arrhythmia which was consistent with atrial
tachycardia or another SVT with a new right bundle branch
block.  His BP was stable but his heart rate was in the
150's.  He was started on Lopressor and Norvasc.  On
postoperative day #2 he had ongoing problems controlling his
rate.  He continued to require beta blockers for rate
control.  Dilt was added.  Cardiology consult was obtained.
When the patient's blood pressure became low, 70/44, the
patient was cardioverted and loaded with Amiodarone and
transferred to the SICU.  There he was started on a Heparin
drip for anticoagulation.  Postoperative day #3 he was
transferred back to the floor.  He did not hold sinus rhythm
and went back into his SVT.  Lopressor was again used for
rate control.  On postoperative day #4 the patient ruled out
by enzymes.  He did have intermittent episodes of SVT but
none of them were sustained.  It was believed that some
combination of the cardioversion and the Amiodarone was
controlling him.  On postoperative day #5 the EP service
recommended long term anticoagulation with Coumadin.  He was
transferred to medicine to be observed until his INR became
therapeutic.  However, several hours after he had been
transferred to medicine, the patient had an episode of
hematemesis of bright red blood.  He passed out in the
bathroom.  An NG tube was dropped, the patient's lavage was
initially bloody but cleared with one liter of fluid.  The
patient was scheduled for an EGD the next day.  Postoperative
day #6 the patient did have the EGD which revealed no source
of bleeding.  It was believed that he may have had a
hematobilia although we cannot be sure in that it stopped on
its own.  On postoperative day #7 the patient continued to be
stable.  He ate a normal diet and tolerated it well.  After
discussion with his primary care physician it was decided
that since his cancer carries such a poor prognosis, there is
no point in subjecting him to long-term anticoagulation with
the inherent risk of recurrent bleeds.  It was decided that
although he may intermittently go into atrial fibrillation,
we should send him home and give him as much time as possible
with his family.  He was evaluated by the PT service who
recommended he stay one day further so that they can improve
his strength.  On the day of discharge his strength was
reasonable so that he could climb stairs which he would have
to do at home.  He was cleared by PT and it was decided to
send him home.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  To home.

DISCHARGE DIAGNOSIS:
1.  Gallbladder adenocarcinoma.
2.  Atrial fibrillation.

DISCHARGE MEDICATIONS:  Aspirin 81 mg q d, Levofloxacin 500
mg po q d for 7 more days, Glyburide 5 mg po q d, Amiodarone
400 mg po bid for now and then with a taper, Lopressor 50 mg
[**Hospital1 **], Lasix 40 mg q d.

FOLLOW-UP:  Dr. [**Last Name (STitle) 1683**], the patient's primary care physician.
[**Name10 (NameIs) **] Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] of oncology.




                          [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 8873**] [**Name8 (MD) **], M.D.  [**MD Number(1) 8874**]

Dictated By:[**Last Name (NamePattern1) 1213**]

MEDQUIST36

D:  [**2193-1-17**]  09:54
T:  [**2193-1-19**]  10:55
JOB#:  [**Job Number 34417**]
{'Malignant neoplasm of gallbladder,Atrial fibrillation,Hematemesis,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential 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: Mr. [**Known lastname 22371**] is a 75-year-old male
admitted electively on [**1-9**] for an exploratory laparoscopy to
evaluate a gallbladder mass he is known to have.  He had
presented earlier in the year with obstructive jaundice and a
He was initially evaluated and cared for by Dr. [**Last Name (STitle) **].  He
had significant hemobilia at that time which was proven by
ERCP.  He was stabilized once and an embolization procedure
of the right hepatic arterial branch pseudoaneurysm was
performed.  His liver function tests improved and he was
discharged home.  He returned on the 6th for this admission
for a procedure to do an exploratory laparoscopy to evaluate
complaints.

MEDICAL HISTORY: Significant for diabetes and
hypertension.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: He is married with one daughter active in
his care.  Rare alcohol, denies tobacco. 

### Response:
{'Malignant neoplasm of gallbladder,Atrial fibrillation,Hematemesis,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Unspecified essential hypertension'}
