CHIEF COMPLAINT: s/p Self inflicted stab wounds to abdomen

PRESENT ILLNESS: 70M w/ pancreatic cancer, s/p self-inflicted stab wounds to
subxiphoid and LUQ of abdomen; found by son in pool of blood;
knife in place upon presentation

MEDICAL HISTORY: PMH: DM, pancreatic non secreting islet cell cancer w. liver
mets, hepatic abscess
PSH:pancreatecomy; splenectomy; sleeve resection of the stomach;
radiofrequency ablation and hepatic embolization for liver mets,
which failed

MEDICATION ON ADMISSION: Unknown

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: 
Injury to other gastrointestinal sites, with open wound into cavity,Injury to other intra-abdominal organs with open wound into cavity, retroperitoneum,Pneumonia, organism unspecified,Malignant neoplasm of pancreas, part unspecified,Malignant neoplasm of liver, secondary,Hyposmolality and/or hyponatremia,Delirium due to conditions classified elsewhere,Suicidal ideation,Suicide and self-inflicted injury by cutting and piercing instrument,Home accidents,Adjustment disorder with depressed mood,Hypotension, unspecified,Peritoneal adhesions (postoperative) (postinfection)
GI injury NEC-open,Retroperitoneum inj-open,Pneumonia, organism NOS,Malig neo pancreas NOS,Second malig neo liver,Hyposmolality,Delirium d/t other cond,Suicidal ideation,Injury-cut instrument,Accident in home,Adjustmnt dis w depressn,Hypotension NOS,Peritoneal adhesions
Admission Date:  [**2127-2-18**]              Discharge Date:   [**2127-2-24**]

Date of Birth:  [**2056-4-23**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 371**]
Chief Complaint:
s/p Self inflicted stab wounds to abdomen

Major Surgical or Invasive Procedure:
[**2127-2-18**] Lysis of adhesions; oversewing of mesentery bleeding
sites


History of Present Illness:
70M w/ pancreatic cancer, s/p self-inflicted stab wounds to
subxiphoid and LUQ of abdomen; found by son in pool of blood;
knife in place upon presentation

Past Medical History:
PMH: DM, pancreatic non secreting islet cell cancer w. liver
mets, hepatic abscess
PSH:pancreatecomy; splenectomy; sleeve resection of the stomach;
radiofrequency ablation and hepatic embolization for liver mets,
which failed


Family History:
Noncontributory

Pertinent Results:
[**2127-2-19**] 12:00AM   WBC-18.8* RBC-3.53* HGB-10.3* HCT-31.4*
MCV-89 MCH-29.3 MCHC-32.9 RDW-13.9
[**2127-2-19**] 12:00AM   PLT COUNT-55*
[**2127-2-19**] 12:00AM   PT-16.4* PTT-36.9* INR(PT)-1.5*
[**2127-2-18**] 11:35PM   GLUCOSE-125* LACTATE-6.5* NA+-128* K+-4.3
CL--104
[**2127-2-18**] 10:43PM   GLUCOSE-107* LACTATE-4.9* NA+-127* K+-4.7
CL--100

Chest xray [**2127-2-18**]
The patient was extubated in the meantime interval. The
cardiomediastinal
silhouette is stable. Bibasal opacities are developed in the
interim and most likely represent areas of atelectasis with most
likely present bilateral small amount of pleural effusion. There
is no evidence of pneumothorax. Mild increase in perihilar
vascular engorgement may be attributed to recent extubation and
increase in the venous return.


Brief Hospital Course:
He was admitted to the Trauma service and transferred to the
Trauma ICU for close monitoring and serial abdominal exams.
Hematocrits were followed closely and remained stable with most
recent value at time of this dictation of 33.

Psychiatry was consulted given the suicide attempt; he was
placed on sitters. Palliative Care/Ethics were also involved in
his care. After several family/team/consultant discussions the
decision was made to discharge patient to home with his family
who were agreeable to this plan.

Medications on Admission:
Unknown

Discharge Medications:
1. Haloperidol 1 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
Disp:*30 Tablet(s)* Refills:*2*
2. Citalopram 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily).
Disp:*30 Tablet(s)* Refills:*2*
3. Augmentin 875-125 mg Tablet Sig: One (1) Tablet PO twice a
day for 10 days.
Disp:*20 Tablet(s)* Refills:*0*
4. Tylenol 325 mg Tablet Sig: Two (2) Tablet PO every 4-6 hours
as needed for fever or pain.
5. Megestrol 40 mg Tablet Sig: One (1) Tablet PO QID (4 times a
day).
Disp:*120 Tablet(s)* Refills:*2*
6. Dilaudid 2 mg Tablet Sig: 1-2 Tablets PO every four (4) hours
as needed for pain.
Disp:*60 Tablet(s)* Refills:*0*
7. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day as
needed for constipation.
8. Milk of Magnesia 800 mg/5 mL Suspension Sig: Thirty (30) ML's
PO twice a day as needed for constipation.
9. Morphine 5 mg Suppository Sig: One (1) Supp Rectal every six
(6) hours as needed for pain.
Disp:*60 suppositories* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
s/p Self-inflicted stab wound to abdomen
Mesenteric injury
Pulmonary edema
Pneumonia

Discharge Condition:
Mental Status: Intermittently awake
Level of Consciousness: Lethargic

Discharge Instructions:
Your famiy has indicated that they would like to take you home
and provide 24 hour services for you.

You were admitted to the hospital after a self-inflicted
stabbing to your abdomen. An operation was performed to explore
your abdominal injuries and repair to one of the arteries in
your abdomen was done.
DO NOT lift objects greater than 10 lbs; avoid bending at your
waist.

Complete the antibitocs as directed for your pneumonia.

Take your medications as prescribed and if you are taking
narcotics take a stool softener and laxative to avoid
constipation.

You may sponge bathe or shower, no tub baths. Avoid letting
water saturate your wound.

Followup Instructions:
Follow up next week in clinic with Dr. [**Last Name (STitle) **] for evalaution
of your operative site and removal of staples. Call([**Telephone/Fax (1) 32046**] for an appointment.

Follow up with your primary providers at [**Hospital3 328**] Cancer
Institute as directed.


Completed by:[**2127-3-20**]
{'Injury to other gastrointestinal sites, with open wound into cavity,Injury to other intra-abdominal organs with open wound into cavity, retroperitoneum,Pneumonia, organism unspecified,Malignant neoplasm of pancreas, part unspecified,Malignant neoplasm of liver, secondary,Hyposmolality and/or hyponatremia,Delirium due to conditions classified elsewhere,Suicidal ideation,Suicide and self-inflicted injury by cutting and piercing instrument,Home accidents,Adjustment disorder with depressed mood,Hypotension, unspecified,Peritoneal adhesions (postoperative) (postinfection)'}


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: s/p Self inflicted stab wounds to abdomen

PRESENT ILLNESS: 70M w/ pancreatic cancer, s/p self-inflicted stab wounds to
subxiphoid and LUQ of abdomen; found by son in pool of blood;
knife in place upon presentation

MEDICAL HISTORY: PMH: DM, pancreatic non secreting islet cell cancer w. liver
mets, hepatic abscess
PSH:pancreatecomy; splenectomy; sleeve resection of the stomach;
radiofrequency ablation and hepatic embolization for liver mets,
which failed

MEDICATION ON ADMISSION: Unknown

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY:  

### Response:
{'Injury to other gastrointestinal sites, with open wound into cavity,Injury to other intra-abdominal organs with open wound into cavity, retroperitoneum,Pneumonia, organism unspecified,Malignant neoplasm of pancreas, part unspecified,Malignant neoplasm of liver, secondary,Hyposmolality and/or hyponatremia,Delirium due to conditions classified elsewhere,Suicidal ideation,Suicide and self-inflicted injury by cutting and piercing instrument,Home accidents,Adjustment disorder with depressed mood,Hypotension, unspecified,Peritoneal adhesions (postoperative) (postinfection)'}
