CHIEF COMPLAINT: Lower abdominal pain

PRESENT ILLNESS: 81 yo female, Russian speaking, with c/o bilateral lower
abdominal pain x3 hours prior to arrival to emergency room;
+nausea, no emesis. Had flatus and a bowel movement earlier
today. Abdominal CT scan revealed + gallstones and ildly dilated
small bowel loops.

MEDICAL HISTORY: Atrial fibrillation
Hypercholesterolemia
Gallstones
h/o SBO
s/p Hysterectomy
Hypertension
Gout

MEDICATION ON ADMISSION: Lipitor
Atenolol
Neurontin
Simethicone
Hydralazine
Lasix
Prilosec
Zoloft

ALLERGIES: Demerol / Droperidol / Penicillamine / Streptomycin / Ampicillin

PHYSICAL EXAM: Upon admission:

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY: 
Intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection),Atrial fibrillation,Congestive heart failure, unspecified,Unspecified essential hypertension,Other and unspecified hyperlipidemia
Intestinal adhes w obstr,Atrial fibrillation,CHF NOS,Hypertension NOS,Hyperlipidemia NEC/NOS
Admission Date:  [**2137-8-19**]              Discharge Date:   [**2137-8-27**]

Date of Birth:  [**2056-8-22**]             Sex:   F

Service: SURGERY

Allergies:
Demerol / Droperidol / Penicillamine / Streptomycin / Ampicillin

Attending:[**First Name3 (LF) 2534**]
Chief Complaint:
Lower abdominal pain

Major Surgical or Invasive Procedure:
Exploratory lap with lysis of adhesions [**2137-8-19**]


History of Present Illness:
81 yo female, Russian speaking, with c/o bilateral lower
abdominal pain x3 hours prior to arrival to emergency room;
+nausea, no emesis. Had flatus and a bowel movement earlier
today. Abdominal CT scan revealed + gallstones and ildly dilated
small bowel loops.

Past Medical History:
Atrial fibrillation
Hypercholesterolemia
Gallstones
h/o SBO
s/p Hysterectomy
Hypertension
Gout

Family History:
Noncontributory

Physical Exam:
Upon admission:

T 97.7  HR 56  BP 160/64  O2 Sat 98%
Gen: alert
Cor: RRR
Chest: CTA bilaterally
Abd: soft, slightly distended, TTP LUQ, no rebound
Rectum: guaiac negative, no stool
Extr: no C/C/E

Pertinent Results:
Upon admission:

[**2137-8-19**] 05:52PM   GLUCOSE-127* UREA N-25* CREAT-0.9 SODIUM-142
POTASSIUM-3.5 CHLORIDE-105 TOTAL CO2-31 ANION GAP-10
[**2137-8-19**] 05:52PM   CALCIUM-7.8* PHOSPHATE-3.5 MAGNESIUM-1.9
[**2137-8-19**] 05:52PM   WBC-10.5 RBC-3.62* HGB-10.1* HCT-29.5*
MCV-81* MCH-27.9 MCHC-34.4 RDW-15.2
[**2137-8-19**] 05:52PM   PLT COUNT-186
[**2137-8-18**] 11:15PM   PLT COUNT-212
[**2137-8-18**] 11:15PM   PT-11.9 PTT-28.5 INR(PT)-1.0

CT ABDOMEN W/CONTRAST; CT PELVIS W/CONTRAST

Reason: eval: intraabd path
Field of view: 36 Contrast: OPTIRAY

[**Hospital 93**] MEDICAL CONDITION:
80 year old woman with abd pain
REASON FOR THIS EXAMINATION:
eval: intraabd path
CONTRAINDICATIONS for IV CONTRAST: None.

HISTORY: 80-year-old woman with abdominal pain.

COMPARISON: [**2135-9-25**].

IMPRESSION:

1. Dilated mid small bowel loops with a transition to decompress
distal ileum concerning for a partial or early small-bowel
obstruction.

2. Nasogastric tube tip within the esophagus after coiling in
the stomach.

3. Cholelithiasis without evidence of cholecystitis.

CHEST (PORTABLE AP)

Reason: please eval for infiltrates / overload

[**Hospital 93**] MEDICAL CONDITION:
80 yo F s/p SBO OR yesterday for adhesion lysis, poor NGT
output. Now wheezing post some IVF.
REASON FOR THIS EXAMINATION:
please eval for infiltrates / overload
EXAMINATION: AP chest, 6:10 a.m., [**8-21**].

HISTORY: Wheezing.

IMPRESSION: Lateral aspect of the right chest is excluded from
the examination. The remainder of the lungs demonstrates new
moderately severe pulmonary edema and there is also a small left
pleural effusion and superior mediastinal vascular engorgement.
Nasogastric tube can be traced as far as the upper stomach. No
pneumothorax along the imaged pleural surfaces.


Brief Hospital Course:
Patient admitted to the Surgical service under the care of Dr.
[**Last Name (STitle) **]. She was taken to the operating room on [**2137-8-19**] for
exploratory lap and lysis of adhesions. Postoperatively she was
taken to the Surgical ICU. She developed pulmonary edema and was
given Lasix with good diuresis and is being discharged on Lasix
40 mg po BID. Her pain was initially controlled with PCA
Morphine, this was later changed to long acting narcotics (MS
Contin) and Percocet for breakthrough pain. She is tolerating a
regular heart healthy diet and was also placed on an aggressive
bowel regimen.

Physical therapy was consulted and have recommended short term
rehab stay in order to improve overall functional status.

Medications on Admission:
Lipitor
Atenolol
Neurontin
Simethicone
Hydralazine
Lasix
Prilosec
Zoloft


Discharge Medications:
1. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1)
Injection TID (3 times a day).
2. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q4-6H
(every 4 to 6 hours) as needed for pain.
3. Ipratropium Bromide 0.02 % Solution Sig: One (1)  Inhalation
every six (6) hours as needed for shortness of breath or
wheezing.
4. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q4H (every 4 hours) as needed for shortness of breath or
wheezing.
5. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO TID (3
times a day): hold for [**Last Name (un) 940**] stools.
6. Polyethylene Glycol 3350 17 g (100%) Packet Sig: One (1)
Packet PO DAILY (Daily): Mix with 8 oz water or juice.
7. Morphine 15 mg Tablet Sustained Release Sig: One (1) Tablet
Sustained Release PO Q12H (every 12 hours).
8. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: Two (2) Tablet
PO every four (4) hours as needed for breakthrough pain.
9. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
10. Atenolol 50 mg Tablet Sig: Two (2) Tablet PO BID (2 times a
day): hold for HR <60 and/or SBP <110.
11. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO at bedtime.

12. Gabapentin 300 mg Capsule Sig: One (1) Capsule PO TID (3
times a day).
13. Insulin Regular Human 100 unit/mL Solution Sig: One (1)
Injection every six (6) hours as needed for per
fingerstick/sliding scale.
14. Allopurinol 100 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily)
as needed for gout.
15. Furosemide 40 mg Tablet Sig: One (1) Tablet PO BID (2 times
a day): Hold for SBP <110.


Discharge Disposition:
Extended Care

Facility:
[**Hospital3 2558**] - [**Location (un) **]

Discharge Diagnosis:
Partial vs. Early Small Bowel Obstruction


Discharge Condition:
Good


Discharge Instructions:
Return to the Emergency room if you develop fevers, chills,
abdomnal pain, nausea, vomitting and/or any other symptoms that
sre concerning to you.

Followup Instructions:
Follow up with Dr. [**Last Name (STitle) **] in General Surgery Clinic in 1 week,
call [**Telephone/Fax (1) 600**] for an appointment.

Follow up with your Primary Care Doctor (Dr. [**Last Name (STitle) 2450**] after
discharge from rehab.



Completed by:[**2137-9-2**]
{'Intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection),Atrial fibrillation,Congestive heart failure, unspecified,Unspecified essential hypertension,Other and unspecified hyperlipidemia'}


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: Lower abdominal pain

PRESENT ILLNESS: 81 yo female, Russian speaking, with c/o bilateral lower
abdominal pain x3 hours prior to arrival to emergency room;
+nausea, no emesis. Had flatus and a bowel movement earlier
today. Abdominal CT scan revealed + gallstones and ildly dilated
small bowel loops.

MEDICAL HISTORY: Atrial fibrillation
Hypercholesterolemia
Gallstones
h/o SBO
s/p Hysterectomy
Hypertension
Gout

MEDICATION ON ADMISSION: Lipitor
Atenolol
Neurontin
Simethicone
Hydralazine
Lasix
Prilosec
Zoloft

ALLERGIES: Demerol / Droperidol / Penicillamine / Streptomycin / Ampicillin

PHYSICAL EXAM: Upon admission:

FAMILY HISTORY: Noncontributory

SOCIAL HISTORY:  

### Response:
{'Intestinal or peritoneal adhesions with obstruction (postoperative) (postinfection),Atrial fibrillation,Congestive heart failure, unspecified,Unspecified essential hypertension,Other and unspecified hyperlipidemia'}
