CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 58 year-old
gentleman status post gunshot wound to the right jaw just
inferior to the ear with an exit wound in the mouth, here
with comminuted fracture of the mandibular angle and ramus.
Per report of the medical staff the patient was in a car
driving away after an argument when the patient was shot
through the rear window.  The bullet apparently entered his
jaw just inferior to his ear and exited through his mouth.

MEDICAL HISTORY: Hypertension as well as the patient is
status post a nephrectomy as per report.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Closed fracture of mandible, angle of jaw,Unspecified essential hypertension,Open wound of jaw, complicated,Assault by handgun
Fx angle of jaw-closed,Hypertension NOS,Open wound jaw-complicat,Assault-handgun
Admission Date:  [**2121-1-9**]     Discharge Date:  [**2121-1-17**]

Date of Birth:   [**2062-3-18**]     Sex:  M

Service:  plastic surgery

HISTORY OF PRESENT ILLNESS:   The patient is a 58 year-old
gentleman status post gunshot wound to the right jaw just
inferior to the ear with an exit wound in the mouth, here
with comminuted fracture of the mandibular angle and ramus.
Per report of the medical staff the patient was in a car
driving away after an argument when the patient was shot
through the rear window.  The bullet apparently entered his
jaw just inferior to his ear and exited through his mouth.

By report the patient was alert and awake at [**Hospital6 **] pretransfer and was intubated out of concern for his
airway since the full extent of his injuries had not been
obtained.

The patient was then transferred to [**Hospital1 190**] for further evaluation and treatment.  His
initial [**Location (un) 2611**] coma score was 15.

PAST MEDICAL HISTORY:  Hypertension as well as the patient is
status post a nephrectomy as per report.

PHYSICAL EXAMINATION:  The patient was intubated and sedated.
There was a gunshot wound to his right mandible.  An
approximately 1 cm entry wound immediately inferior to the
right ear with approximately 1.5 cm exit wound intraorally.
Track can be appreciated with exposed tendon in field.

LABORATORY STUDIES:  White count 18.9, hematocrit 43,
platelets 225,000, sodium 137, potassium 4.3. BUN 24,
creatinine 1.3, lactate 1.5.  An arterial blood gases showed
a PCO2 of 480, pH 7.28, PCO2 49 and bicarbonate was 24.

Relative imaging revealed a CAT scan of the maxillofacial
indicated a comminuted fracture with shatter with horizontal
plane to the midramus and an oblique fracture plane from
midramus to the angle of the mandible.  There was abundant
metallic shrapnel present.  There was a large right sided
hematoma with multiple subcutaneous air pockets.

HOSPITAL COURSE:  Mr. [**Known lastname **] is a 58 year-old gentleman
status post gunshot wound to the right jaw with mandibular
angle fracture as well as a fracture of the midportion of the
ramus.  The temporomandibular joint was intact.


The patient was admitted initially to the trauma service for
close observation in the Intensive Care Unit.  The patient
continues to be hemodynamically stable.  Aggressive washout
of the wound site was achieved with wet to dry packing of the
wound.  The patient received tetanus as prophylaxis and he
was started on clindamycin 600 mg intravenously t.i.d.  The
patient was initially maintained on ventilatory support until
repaired and was weaned to extubation without any difficulty.

The patient's cervical spine was cleared.  There were no
other injuries elsewhere.  Plastic surgery was consulted for
repair of his mandibular fracture which took place on
[**2121-1-15**].  Please refer to the operative note for further
details.  Nutrition was consulted regarding appropriate p.o.
intake.  His pain was well controlled with p.o. Percocet.
The patient was tolerating a regular soft diet at the time of
discharge.  The patient is to follow up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **]
at the Plastics outpatient clinic for follow up wound care
and suture removal, to be discharged to home with Visiting
Nursing Services.

CONDITION:  Discharged to home with Visiting Nurses Services.

DISCHARGE STATUS:  Stable.

DISCHARGE DIAGNOSES:  The patient is status post gunshot
wound to the right jaw with mandibular fracture.  The patient
is status post mandibular fracture repair.

DISCHARGE MEDICATIONS:  Metoprolol 50 mg one tablet p.o.
b.i.d.  Lipator 30 mg one tablet p.o. q day.  Docusate one
tablet p.o. b.i.d.  Chlorhexidine Gluconate to rinse his
mouth twice a day.  Clindamycin 300 mg one tablet p.o. q6
hours for seven days.  Percocet q4 to 6 hours p.r.n. pain.

FOLLOW PLANS:  The patient is to follow up with Dr. [**First Name8 (NamePattern2) **]
[**Last Name (NamePattern1) **], Phone [**Telephone/Fax (1) 15527**], on [**2121-1-24**] at 10:00 A.M. at the
plastic outpatient office located at the [**Hospital Ward Name 23**] Building,
[**Location (un) 10043**], [**Hospital Ward Name **].  Before discharge the patient is to
be instructed on wound care and to continue rinsing his
mouth, keep his head elevated and to continue his clindamycin
antibiotics for one more week and to restrict his oral intact
only to soft blended foods.


                          [**First Name11 (Name Pattern1) 1216**] [**Last Name (NamePattern4) 2612**], M.D.  [**MD Number(1) 22429**]
Dictated By:[**Last Name (NamePattern1) 12360**]
MEDQUIST36
D:  [**2121-1-17**]  10:53
T:  [**2121-1-20**]  07:12
JOB#:  [**Job Number 53723**]
{'Closed fracture of mandible, angle of jaw,Unspecified essential hypertension,Open wound of jaw, complicated,Assault by handgun'}


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 58 year-old
gentleman status post gunshot wound to the right jaw just
inferior to the ear with an exit wound in the mouth, here
with comminuted fracture of the mandibular angle and ramus.
Per report of the medical staff the patient was in a car
driving away after an argument when the patient was shot
through the rear window.  The bullet apparently entered his
jaw just inferior to his ear and exited through his mouth.

MEDICAL HISTORY: Hypertension as well as the patient is
status post a nephrectomy as per report.

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Closed fracture of mandible, angle of jaw,Unspecified essential hypertension,Open wound of jaw, complicated,Assault by handgun'}
