CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient was a 26-year-old
female who was involved in a motor vehicle accident as an
unrestrained passenger at high speed with rollover and
prolonged extrication of approximately 20-30 minutes. The
patient was initially seen at an outside hospital where she
was found to have a severe scalp laceration of the left
frontal region, as well as splenic laceration and a liver
laceration. The patient was subsequently transferred.

MEDICAL HISTORY: Hepatitis C, IV drug abuse. She is
status post a tubal ligation.

MEDICATION ON ADMISSION: None.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Other injury into spleen without mention of open wound into cavity,Injury to liver without mention of open wound into cavity, unspecified injury,Unspecified viral hepatitis C without hepatic coma,Cocaine abuse, unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring passenger in motor vehicle other than motorcycle,Open wound of scalp, without mention of complication
Spleen injury NEC-closed,Liver injury NOS-closed,Hpt C w/o hepat coma NOS,Cocaine abuse-unspec,Mv collision NOS-pasngr,Open wound of scalp
Admission Date: [**2134-4-14**]        Discharge Date: [**2134-4-18**]

Date of Birth:  [**2108-3-11**]        Sex:  F

Service:  TRA


HISTORY OF PRESENT ILLNESS:  The patient was a 26-year-old
female who was involved in a motor vehicle accident as an
unrestrained passenger at high speed with rollover and
prolonged extrication of approximately 20-30 minutes. The
patient was initially seen at an outside hospital where she
was found to have a severe scalp laceration of the left
frontal region, as well as splenic laceration and a liver
laceration. The patient was subsequently transferred.

The patient denied any loss of consciousness. It was unclear
if the patient had a head injury. [**Location (un) 2611**] coma scale on
admission was 15, and there was some evidence of tachycardia.

PAST MEDICAL HISTORY:  Hepatitis C, IV drug abuse. She is
status post a tubal ligation.

MEDICATIONS ON ADMISSION:  None.

ALLERGIES:  No known drug allergies.

PHYSICAL EXAMINATION:  Vital signs: Temperature 99.4, heart
rate 119, blood pressure 116/50, respirations 16/min, oxygen
saturation 100% on room air. General: She had a GCS of 15.
HEENT: She had an approximately 8 cm left frontal parietal
laceration. Pupils equal, round and reactive to light and
accommodation. Extraocular movements intact. Tympanic
membranes clear. Neck: Her trache was noted to be midline.
Chest: She had a right breast contusion. Lungs: Clear to
auscultation bilaterally. Cardiovascular: Regular rate with
tachycardia. Abdomen: The subxiphoid region was noted to be
tender; however, the abdomen was soft and nondistended. There
was a left upper quadrant ecchymosis. Rectal: She had normal
tone, no stool, guaiac negative. Pelvis: Stable. Back: There
was severe left thoracolumbar abrasion. There was no
deformity. There was some tenderness from T8 to the sacrum.
Extremities: She had a right wrist laceration, approximately
1 cm. She had 2+ dorsalis pedis, posterior tibial, and radial
pulses bilaterally.

LABORATORY DATA:  Initial laboratories were significant for a
white blood cell count of 22.6, hematocrit 33, platelet count
268,000; PT 14.3, PTT 22.7, INR 1.3, fibrinogen 153;
chemistry showed a sodium of 145, potassium 4.8, chloride
112, bicarbonate 26, BUN 11, creatinine 0.7, glucose 145;
serum toxicology screen was positive for barbiturates and at
the outside hospital was positive for cocaine.

EKG showed sinus tachycardia. Chest x-ray showed no fracture
or pneumothorax. Pelvis showed no fracture and no dislocation
and some presence of some old contrast.

CAT scan from the outside hospital revealed her head to be
negative. Cervical spine showed no fracture or dislocation
including reconstructed images. CT of her abdomen showed an
upper pole contained splenic laceration, as well as a left
lobe liver laceration in segment IV.

CT of her abdomen and pelvis at [**Hospital3 **] was significant
for liver laceration, a splenic laceration extending into the
hilum, small high attenuation focus in the right lower
quadrant with surrounding hematoma which may represent active
extravasation of the small vessel, perihepatic and
perisplenic hemorrhage with hemorrhage seen tracking along
the pericolic gutters and into the pelvis which is increased
compared to the outside hospital CAT scan, a tiny stable
pneumothorax, a left adnexal cyst, and no evidence of bladder
rupture.

HOSPITAL COURSE:  The patient was admitted to the surgical
intensive care unit for serial hematocrits and close
monitoring. She remained in the intensive care unit until
[**2134-4-17**], post injury date #3, at which time she was
transferred to the floor in stable condition. She was
ultimately discharged on [**2134-4-18**].

1. Contained splenic and liver lacerations: These two
   injuries were managed nonoperatively with serial
   hematocrits and close hemodynamic monitoring. Of note, the
   patient did receive 1 unit of packed red blood cells and 2
   units of fresh frozen plasma initially, as well as 5 units
   of intravenous fluids, and her hematocrits were noted to
   trend down despite this resuscitation and transfusion from
   a high 33 on admission on [**2134-4-14**], down to 24.4 on
   post injury day #1, [**2134-4-15**]. Hematocrits ultimately
   stabilized, and at the time of discharge, her hematocrit
   was 28.4 on [**2134-4-18**], in the morning.

She did have some abdominal tenderness from these injuries.
This was initially managed with patient-controlled analgesia.
The patient was ultimately converted to oral Dilaudid, on
which she was sent out with.

1. Scalp laceration: The patient had a scalp laceration which
   was treated with stapling and appeared non-infected and to
   be clean, dry, and intact. The patient was discharged with
   strict instructions to return to the trauma clinic for
   removal of staples.

1. Neck pain: Despite having a CAT scan from the outside
   hospital which was negative for any fractures or
   dislocations, the patient did have continued cervical
   spine pain and ultimately underwent a flexion/extension
   examination which demonstrated only grade I retrolisthesis
   of C4 and C5 on extension which reduced with flexion. The
   patient's cervical spine was then cleared clinically, and
   the collar was removed, and the patient was discharged
   without the collar.


CONDITION ON DISCHARGE:  Stable.

DISCHARGE DIAGNOSIS:
1. Splenic laceration.
2. Liver laceration.
3. Scalp laceration.
4. Hepatitis C.


DISCHARGE MEDICATIONS:  Colace 100 mg twice a day, Dilaudid 2
mg [**1-3**] tab every 4-6 hours, Fioricet 325 40 and 50 mg [**1-3**] tab
every 4-6 hours as needed for migraine headaches.

DISCHARGE INSTRUCTIONS:  The patient was instructed to follow-
up in the trauma clinic in [**7-11**] days for removal of staples
and follow-up with her splenic and liver lacerations. She was
given phone number [**Telephone/Fax (1) 60496**] to call for both an
appointment and directions. In addition, the patient was
instructed to follow-up with her primary care provider or
hepatologist concerning her hepatitis C and any possible
repercussions or complications of her liver laceration. In
addition, the patient was instructed to be involved in no
contact sports, heavy lifting, or do any strenuous activity
until directed otherwise by the trauma surgeons.



                        [**First Name11 (Name Pattern1) 518**] [**Last Name (NamePattern4) **], [**MD Number(1) 17554**]

Dictated By:[**Last Name (NamePattern1) 39725**]
MEDQUIST36
D:  [**2134-4-20**] 20:17:10
T:  [**2134-4-21**] 09:38:33
Job#:  [**Job Number 60497**]
{'Other injury into spleen without mention of open wound into cavity,Injury to liver without mention of open wound into cavity, unspecified injury,Unspecified viral hepatitis C without hepatic coma,Cocaine abuse, unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring passenger in motor vehicle other than motorcycle,Open wound of scalp, without mention of complication'}


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 was a 26-year-old
female who was involved in a motor vehicle accident as an
unrestrained passenger at high speed with rollover and
prolonged extrication of approximately 20-30 minutes. The
patient was initially seen at an outside hospital where she
was found to have a severe scalp laceration of the left
frontal region, as well as splenic laceration and a liver
laceration. The patient was subsequently transferred.

MEDICAL HISTORY: Hepatitis C, IV drug abuse. She is
status post a tubal ligation.

MEDICATION ON ADMISSION: None.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Other injury into spleen without mention of open wound into cavity,Injury to liver without mention of open wound into cavity, unspecified injury,Unspecified viral hepatitis C without hepatic coma,Cocaine abuse, unspecified,Other motor vehicle traffic accident involving collision with motor vehicle injuring passenger in motor vehicle other than motorcycle,Open wound of scalp, without mention of complication'}
