CHIEF COMPLAINT: gallstone pancreatitis

PRESENT ILLNESS: Patient is a 45 year old female transferred from [**Hospital3 **]
on [**2120-8-7**] for treatment of pancreatitis. Patient
presented to [**Hospital1 **] after a syncopal episode. Postive reports of
R abdominal and back pain after eating fatty meals in the past.
At [**Hospital1 **], lipase 7474m antkase 2,490, ALT 402, AST 463, bili
1.5, Alk Phos 130, WBC 17. CT demonstrated cholecystitis,
cholelithiasis, intrahepatic ductal dilatation and pacreatitis
with surrounding phlegmon. She improved on cefotetan, imopenem
and hydration. On [**8-6**], patient symptoms became acutely
worse and developed grey-[**Doctor Last Name **] sign. Repeat CT demonstrated
increase in abdominal fluid, increase in pancreatic inflamation,
increase [**Last Name (un) **] of phlegman, new pleural effusions. Patient
arrived to [**Hospital1 18**] intensive care unit [**2120-8-7**].

MEDICAL HISTORY: none

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 99.2 158/70 89 24 94% 5L
diaphoretic
dry MMM
tachy regular
dull @ bases bilaterally, poor inspiratory effort
tense echymosis over flanks bilaterally, tender, distended, no
rebound
mild lowere extremity edema

FAMILY HISTORY: Denies CAD, cancer, or gallstones

SOCIAL HISTORY: Denies EtOH, Tobacco or IDU
Acute pancreatitis,Calculus of gallbladder with acute cholecystitis, without mention of obstruction,Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled
Acute pancreatitis,Cholelith w ac cholecyst,DMI wo cmp nt st uncntrl
Admission Date:  [**2120-8-7**]              Discharge Date:   [**2120-8-20**]

Date of Birth:  [**2074-11-30**]             Sex:   F

Service: [**Doctor First Name 147**]

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 148**]
Chief Complaint:
gallstone pancreatitis

Major Surgical or Invasive Procedure:
none


History of Present Illness:
Patient is a 45 year old female transferred from [**Hospital3 **]
on [**2120-8-7**] for treatment of pancreatitis. Patient
presented to [**Hospital1 **] after a syncopal episode. Postive reports of
R abdominal and back pain after eating fatty meals in the past.
At [**Hospital1 **], lipase 7474m antkase 2,490, ALT 402, AST 463, bili
1.5, Alk Phos 130, WBC 17. CT demonstrated cholecystitis,
cholelithiasis, intrahepatic ductal dilatation and pacreatitis
with surrounding phlegmon. She improved on cefotetan, imopenem
and hydration. On [**8-6**], patient symptoms became acutely
worse and developed grey-[**Doctor Last Name **] sign. Repeat CT demonstrated
increase in abdominal fluid, increase in pancreatic inflamation,
increase [**Last Name (un) **] of phlegman, new pleural effusions. Patient
arrived to [**Hospital1 18**] intensive care unit [**2120-8-7**].

Past Medical History:
none

Social History:
Denies EtOH, Tobacco or IDU

Family History:
Denies CAD, cancer, or gallstones

Physical Exam:
99.2 158/70 89 24 94% 5L
diaphoretic
dry MMM
tachy regular
dull @ bases bilaterally, poor inspiratory effort
tense echymosis over flanks bilaterally, tender, distended, no
rebound
mild lowere extremity edema

Pertinent Results:
[**2120-8-7**] 08:06PM   LACTATE-1.0
[**2120-8-7**] 07:12PM   GLUCOSE-155* UREA N-19 CREAT-0.5 SODIUM-153*
POTASSIUM-3.8 CHLORIDE-113* TOTAL CO2-30* ANION GAP-14
[**2120-8-7**] 07:12PM   ALT(SGPT)-42* AST(SGOT)-21 ALK PHOS-90
AMYLASE-80 TOT BILI-0.4
[**2120-8-7**] 07:12PM   LIPASE-33
[**2120-8-7**] 07:12PM   CALCIUM-7.9* PHOSPHATE-2.1* MAGNESIUM-2.5
[**2120-8-7**] 07:12PM   WBC-14.9* RBC-3.35* HGB-8.4* HCT-27.3*
MCV-81* MCH-25.1* MCHC-30.8* RDW-16.8*
[**2120-8-7**] 07:12PM   NEUTS-75* BANDS-0 LYMPHS-15* MONOS-8 EOS-2
BASOS-0 ATYPS-0 METAS-0 MYELOS-0
[**2120-8-7**] 07:12PM   PT-14.2* PTT-19.7* INR(PT)-1.3

Brief Hospital Course:
On arrival to medical intensive care unit, patient was stable
and supportive measures were continued.  Imipenan was continued.
Patient remained stable and was started on TPN and transferred
to the surgical intensive care unit on [**8-8**]. Patient
continue to improve in both clinical appearance and in lab
values and was transferred to the floor [**8-10**]. Sugars
were monitored and patient required insulin. Patient was
advanced low fat diet on [**8-16**] which she tolerated well. A
[**Last Name (un) 387**] consult was obtained for patients new onset of diabetes.
A cholecystectomy was planned during the hospital admission was
but then cancelled secondary to a large pseudocyst demonstrated
on CT. Patient was discharged on [**8-20**] with surgical and
[**Last Name (un) 387**] follow upl

Medications on Admission:
none

Discharge Medications:
1. Lantus 100 unit/mL Solution Sig: Eight (8) units Subcutaneous
at bedtime.
Disp:*30 * Refills:*2*
2. Humalog 100 unit/mL Solution Sig: per sliding scale unit
Subcutaneous with meals.
Disp:*100 * Refills:*2*
3. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4-6H (every 4 to 6 hours) as needed.
Disp:*50 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
insulin dependent diabetes
gallstone necrotizing pancreatitis
cholelithiasis


Discharge Condition:
good

Discharge Instructions:
Take medications as perscribed.
Call doctor or report to emergency if develop abdominal pain,
naseau or vomiting

Followup Instructions:
Patient to call and make appointment with Dr.[**Name (NI) 2829**] office
in one month. Office will arrange for patient to have repeat CT
scan that AM.



[**Hospital **] Clinic- [**2120-9-11**] 10 am with Dr.[**Last Name (STitle) **] [**Telephone/Fax (1) 55107**]

Patient to follow up with Dr.[**Name (NI) 56952**] office regarding diabetic
nutrition education classes.
{'Acute pancreatitis,Calculus of gallbladder with acute cholecystitis, without mention of obstruction,Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled'}


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: gallstone pancreatitis

PRESENT ILLNESS: Patient is a 45 year old female transferred from [**Hospital3 **]
on [**2120-8-7**] for treatment of pancreatitis. Patient
presented to [**Hospital1 **] after a syncopal episode. Postive reports of
R abdominal and back pain after eating fatty meals in the past.
At [**Hospital1 **], lipase 7474m antkase 2,490, ALT 402, AST 463, bili
1.5, Alk Phos 130, WBC 17. CT demonstrated cholecystitis,
cholelithiasis, intrahepatic ductal dilatation and pacreatitis
with surrounding phlegmon. She improved on cefotetan, imopenem
and hydration. On [**8-6**], patient symptoms became acutely
worse and developed grey-[**Doctor Last Name **] sign. Repeat CT demonstrated
increase in abdominal fluid, increase in pancreatic inflamation,
increase [**Last Name (un) **] of phlegman, new pleural effusions. Patient
arrived to [**Hospital1 18**] intensive care unit [**2120-8-7**].

MEDICAL HISTORY: none

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 99.2 158/70 89 24 94% 5L
diaphoretic
dry MMM
tachy regular
dull @ bases bilaterally, poor inspiratory effort
tense echymosis over flanks bilaterally, tender, distended, no
rebound
mild lowere extremity edema

FAMILY HISTORY: Denies CAD, cancer, or gallstones

SOCIAL HISTORY: Denies EtOH, Tobacco or IDU 

### Response:
{'Acute pancreatitis,Calculus of gallbladder with acute cholecystitis, without mention of obstruction,Diabetes mellitus without mention of complication, type I [juvenile type], not stated as uncontrolled'}
