CHIEF COMPLAINT: Abdominal pain.

PRESENT ILLNESS: The patient is a 73-year-old
white male physician with [**Name Initial (PRE) **] past medical history significant
for myocardial infarction who presented to the [**Hospital1 **] with two days of epigastric pain associated with
fever and chills.  On admission, the patient was hypotensive
with a systolic blood pressure in the 60s and with creatinine
2.7.  CT scan of the abdomen and pelvis obtained revealed
dilated intrahepatic ducts and 1.5 cm stone in the common
bile duct with a dilated common bile duct.

MEDICAL HISTORY: 1. Status post myocardial infarction.
2. Hypertension.
3. Status post cholecystectomy in [**2127**].  Current ejection
   fraction 58 percent from a negative MIBI obtained in [**2141**].

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient is a retired pediatrician.  He
denied tobacco, alcohol, or illicit drug use.
Unspecified septicemia,Acute kidney failure, unspecified,Cholangitis,Calculus of bile duct without mention of cholecystitis, with obstruction,Severe sepsis,Unspecified essential hypertension,Old myocardial infarction
Septicemia NOS,Acute kidney failure NOS,Cholangitis,Choledochlith NOS w obst,Severe sepsis,Hypertension NOS,Old myocardial infarct
Admission Date: [**2142-2-7**]        Discharge Date: [**2142-2-12**]

Date of Birth:  [**2062-5-15**]        Sex:  M

Service:  [**Last Name (un) **]


CHIEF COMPLAINT:  Abdominal pain.

HISTORY OF PRESENT ILLNESS:  The patient is a 73-year-old
white male physician with [**Name Initial (PRE) **] past medical history significant
for myocardial infarction who presented to the [**Hospital1 **] with two days of epigastric pain associated with
fever and chills.  On admission, the patient was hypotensive
with a systolic blood pressure in the 60s and with creatinine
2.7.  CT scan of the abdomen and pelvis obtained revealed
dilated intrahepatic ducts and 1.5 cm stone in the common
bile duct with a dilated common bile duct.

PAST MEDICAL HISTORY:
1. Status post myocardial infarction.
2. Hypertension.
3. Status post cholecystectomy in [**2127**].  Current ejection
   fraction 58 percent from a negative MIBI obtained in [**2141**].


ALLERGIES:  The patient has no known drug allergies.

MEDICATIONS:
1. Aspirin 81 mg once daily.
2. Atenolol 25 mg once daily.
3. Vasotec 2.5 mg once daily.
4. Lipitor 10 mg once daily.


SOCIAL HISTORY:  The patient is a retired pediatrician.  He
denied tobacco, alcohol, or illicit drug use.

FAMILY HISTORY:  Noncontributory.

PHYSICAL EXAMINATION:  On physical examination, the vital
signs were 99.1, 95, 108/69, 17, 99 percent on 2 liters.  In
general, the patient was alert.  He was oriented times three.
He does not appear in any acute distress.  HEENT:  The pupils
were equal, round, and reactive to light.  Normocephalic.  No
JVD, lymphadenopathy, or thyromegaly noted.  CV:  Regular
rate and rhythm without murmur.  Pulmonary:  Clear to
auscultation bilaterally.  Abdomen:  Nondistended, soft,
nontender to palpation.  Extremities:  No peripheral edema.
Distal neurovascular intact.  Neurologic:  The patient is
moving all extremities.  Cranial nerves II through XII
intact.  Good motor and sensory function.

HOSPITAL COURSE:  The patient presented to the [**Hospital1 346**] on [**2142-2-7**] with complaints of
epigastric pain associated with fevers and chills times two
days.  On admission, the patient's systolic blood pressure
was in the 60s and his creatinine was 2.7.  He was given
intravenous fluids which increased his blood pressure.  A CT
scan of the abdomen and pelvis revealed dilated intrahepatic
ducts with dilated common bile ducts and a 1.5 cm stone in
the common bile duct associated with evidence of cholangitis.
His lactate was 8.6.  White blood cell count 14.4.  The GI
ERCP service was contact[**Name (NI) **] and the patient underwent emergent
ERCP with sphincterotomy and stent placement.  The patient's
condition soon stabilized.  He remained afebrile and in a
stable condition throughout the rest of his hospital course.
He remained in the ICU for observation until hospital day
number three, at which time he was transferred to the floor
in stable condition.

Cardiology was consulted who recommended an echocardiogram
which was obtained and revealed no evidence of vegetation
with a normal EF of greater than 55 percent.  The patient's
laboratory values continued to trend downward including his
white blood cell count which was 10 on the day of discharge
and his total bilirubin which decreased from a level of 5 on
admission to 1.0 on discharge.

By hospital day number five, the patient was ambulating
easily and again he was afebrile with vital signs very
stable.  He was tolerating a regular diet.  He was without
pain.  He was discharged in good condition on hospital day
number six with instructions to follow-up with the ERCP
attending and also with Dr. [**Last Name (STitle) **].

DISCHARGE MEDICATIONS:
1. Aspirin 81 mg once daily.
2. Enalapril 2.5 mg p.o. once daily.
3. Atenolol 25 mg p.o. once daily.
4. Levofloxacin 250 mg p.o. once daily times ten days.
5. Flagyl 500 mg p.o. three times daily times ten days.


DISCHARGE INSTRUCTIONS:  The patient is to seek medical
attention if he experiences fever, chills, nausea, vomiting,
or increased abdominal pain.

FINAL DIAGNOSIS:  Acute cholangitis.

RECOMMENDED FOLLOW UP:  Dr.[**Name (NI) 22019**] office at [**Telephone/Fax (1) 10533**]
within the next few days after discharge in order to make a
follow-up appointment.  The patient is to contact Dr.[**Name (NI) 95510**] office at [**Telephone/Fax (1) 2799**] within the next week after
discharge to schedule a follow-up appointment.

MAJOR SURGICAL OR INVASIVE PROCEDURES:  ERCP.

CONDITION ON DISCHARGE:  Good.



                        [**Name6 (MD) **] [**Name8 (MD) **], [**MD Number(1) 23293**]

Dictated By:[**Last Name (NamePattern1) 16264**]
MEDQUIST36
D:  [**2142-2-12**] 16:12:53
T:  [**2142-2-12**] 17:21:33
Job#:  [**Job Number 95511**]
{'Unspecified septicemia,Acute kidney failure, unspecified,Cholangitis,Calculus of bile duct without mention of cholecystitis, with obstruction,Severe sepsis,Unspecified essential hypertension,Old myocardial infarction'}


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: Abdominal pain.

PRESENT ILLNESS: The patient is a 73-year-old
white male physician with [**Name Initial (PRE) **] past medical history significant
for myocardial infarction who presented to the [**Hospital1 **] with two days of epigastric pain associated with
fever and chills.  On admission, the patient was hypotensive
with a systolic blood pressure in the 60s and with creatinine
2.7.  CT scan of the abdomen and pelvis obtained revealed
dilated intrahepatic ducts and 1.5 cm stone in the common
bile duct with a dilated common bile duct.

MEDICAL HISTORY: 1. Status post myocardial infarction.
2. Hypertension.
3. Status post cholecystectomy in [**2127**].  Current ejection
   fraction 58 percent from a negative MIBI obtained in [**2141**].

MEDICATION ON ADMISSION: 

ALLERGIES: The patient has no known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: The patient is a retired pediatrician.  He
denied tobacco, alcohol, or illicit drug use. 

### Response:
{'Unspecified septicemia,Acute kidney failure, unspecified,Cholangitis,Calculus of bile duct without mention of cholecystitis, with obstruction,Severe sepsis,Unspecified essential hypertension,Old myocardial infarction'}
