CHIEF COMPLAINT: acute cholecystitis

PRESENT ILLNESS: 53yF presents w/acute onset epigastric pain radiating to the
right side. +nausea/vomiting, +chills. Patient reports similar
episode one week prior.

MEDICAL HISTORY: HTN
DM
CAD
s/p cesarean 20yrs ago

MEDICATION ON ADMISSION: diltiazem, fembrozil, metamucil, ASA 81'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen: well appearing nad
Heent: perrl, eomi, nares patent, oropharynx without
erythema/exudate
Neck: supple, no masses
CV: rrr, no m/r/g
Resp: cta bilaterally
Abd: soft, NTND, incisions c/d/i
Ext: no edema
Neuro: aao x 4

FAMILY HISTORY: NC

SOCIAL HISTORY: From [**Country **], lives with stepfather in [**Location (un) **]. No tobacco,
no EtOH.
Calculus of gallbladder and bile duct with acute and chronic cholecystitis, without mention of obstruction,Cholangitis,Anemia, unspecified,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Unspecified late effects of cerebrovascular disease
Gal&bil cal w/ac&chr w/o,Cholangitis,Anemia NOS,Hypertension NOS,DMII wo cmp nt st uncntr,Crnry athrscl natve vssl,Angina pectoris NEC/NOS,Late effect CV dis NOS
Admission Date:  [**2156-12-27**]              Discharge Date:   [**2157-1-10**]

Date of Birth:  [**2103-11-30**]             Sex:   F

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 5547**]
Chief Complaint:
acute cholecystitis

Major Surgical or Invasive Procedure:
lap cholecystectomy [**2156-12-27**]


History of Present Illness:
53yF presents w/acute onset epigastric pain radiating to the
right side. +nausea/vomiting, +chills. Patient reports similar
episode one week prior.

Past Medical History:
HTN
DM
CAD
s/p cesarean 20yrs ago


Social History:
From [**Country **], lives with stepfather in [**Location (un) **]. No tobacco,
no EtOH.

Family History:
NC

Physical Exam:
Gen: well appearing nad
Heent: perrl, eomi, nares patent, oropharynx without
erythema/exudate
Neck: supple, no masses
CV: rrr, no m/r/g
Resp: cta bilaterally
Abd: soft, NTND, incisions c/d/i
Ext: no edema
Neuro: aao x 4

Pertinent Results:
[**2157-1-10**] 06:40AM BLOOD WBC-11.7* RBC-3.60* Hgb-11.2* Hct-32.1*
MCV-89 MCH-31.1 MCHC-34.8 RDW-14.4 Plt Ct-1117*
[**2157-1-8**] 02:00AM BLOOD WBC-13.7* RBC-3.41* Hgb-10.5* Hct-30.2*
MCV-89 MCH-30.7 MCHC-34.7 RDW-14.0 Plt Ct-971*
[**2157-1-10**] 06:40AM BLOOD Plt Smr-VERY HIGH Plt Ct-1117*
[**2157-1-8**] 02:00AM BLOOD Plt Ct-971*
[**2157-1-8**] 02:00AM BLOOD Glucose-199* UreaN-18 Creat-0.4 Na-140
K-4.6 Cl-105 HCO3-29 AnGap-11
[**2157-1-8**] 02:00AM BLOOD Calcium-8.3* Phos-3.5 Mg-2.2

Brief Hospital Course:
Patient admitted and underwent an uncomplicated lap chole. She
was transferred extubated and stable to the recovery room and
then to the floor. POD1 she had some pain but was otherwise
stable. She was noted to have a fever to 101.6 overnight.  An
ERCP was performed on POD2 secondary to a filling defect of the
CBD noted intraoperatively. ERCP was performed revealing a
retained stoned which was drained. Post procedure, patient noted
to require increasing oxygen to maintain oxygen saturations, a
CXR demonstrated bilateral infiltrates. Overnight, she developed
respiratory failure requiring emergent intubation. Patient was
transferred to the SICU for further management. She was placed
on broad spectrum antibiotics for ?pneumonia and managed on
maximal vent support as well as TPN for nutrition. Over the next
few days, the patient's CXR demonstrated diffuse bilateral
infiltrates c/w ARDS. She intermittently spiked temperatures and
was subsequently pan cultured. She was diuresed gently and
started on tube feedings for nutrition. POD7 a dobhoff feeding
tube was placed for nutrition. She remained stable and intubated
in the ICU. Her vent setting were slowly weaned to minimal
support. POD10 she was extubated successfully. POD11 she passed
a bedside swallow study and was started on sips. She was
continued on TPN. She was weaned to oxygen via nasal cannula and
remained afebrile. POD13 she was transferred to the floor. She
was OOB with physical therapy and tolerating a regular diet. At
the time of discharge, all of her cultures had returned no
growth to date. On POD14 she was discharged to home in good
condition and on room air and instructed to follow up with Dr.
[**Last Name (STitle) 1924**]. She was also instructed to follow up with her primary
care physician as soon as possible for management of her blood
sugars and her blood pressure.

Medications on Admission:
diltiazem, fembrozil, metamucil, ASA 81'

Discharge Medications:
1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO once a day.
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2*
2. Diltiazem HCl 240 mg Capsule, Sustained Release Sig: One (1)
Capsule, Sustained Release PO once a day.
Disp:*30 Capsule, Sustained Release(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
[**Location (un) 86**] VNA

Discharge Diagnosis:
choleystitis
respiratory failure


Discharge Condition:
good


Discharge Instructions:
Please go the emergency room if you have fever, nausea/vomiting,
abdominal pain, dizziness/weakness or shortness of breath. Go
the emergency room if you have redness, bleeding or oozing from
your surgical site.
Keep your surgical wounds clean and dry. You can shower
normally.

Followup Instructions:
Please follow up with Dr. [**Last Name (STitle) 1924**] in [**1-28**] weeks. Call [**Telephone/Fax (1) 7508**]
for an appointment.
{'Calculus of gallbladder and bile duct with acute and chronic cholecystitis, without mention of obstruction,Cholangitis,Anemia, unspecified,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Unspecified late effects of cerebrovascular disease'}


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: acute cholecystitis

PRESENT ILLNESS: 53yF presents w/acute onset epigastric pain radiating to the
right side. +nausea/vomiting, +chills. Patient reports similar
episode one week prior.

MEDICAL HISTORY: HTN
DM
CAD
s/p cesarean 20yrs ago

MEDICATION ON ADMISSION: diltiazem, fembrozil, metamucil, ASA 81'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: Gen: well appearing nad
Heent: perrl, eomi, nares patent, oropharynx without
erythema/exudate
Neck: supple, no masses
CV: rrr, no m/r/g
Resp: cta bilaterally
Abd: soft, NTND, incisions c/d/i
Ext: no edema
Neuro: aao x 4

FAMILY HISTORY: NC

SOCIAL HISTORY: From [**Country **], lives with stepfather in [**Location (un) **]. No tobacco,
no EtOH. 

### Response:
{'Calculus of gallbladder and bile duct with acute and chronic cholecystitis, without mention of obstruction,Cholangitis,Anemia, unspecified,Unspecified essential hypertension,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Coronary atherosclerosis of native coronary artery,Other and unspecified angina pectoris,Unspecified late effects of cerebrovascular disease'}
