CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 45 year old
male with a 24 year history of ulcerative colitis, who on
recent colonoscopy was found to have marked polypoid changes
in the transverse colon, making ongoing surveillance
impossible in terms of cancer prevention.  The patient's
gastroenterologist performed numerous biopsies in the region
with no dysplasia noted on pathology.  The ascending colon
and cecum were normal grossly as was the rectosigmoid portion
of the colon.  The patient's gastroenterologist also noted
some liver abnormalities on the patient's blood work in terms
of decreased platelet count and elevated AST.

MEDICAL HISTORY: 1.  Hypertension.
2.  Aortic and mitral valve insufficiency.
3.  Alcoholism.
4.  Crohn's disease.

MEDICATION ON ADMISSION: 1.  Wellbutrin.
2.  Sulfasalazine.
3.  Benadryl.
4.  Vitamins.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Ulcerative (chronic) ileocolitis,Pneumonia, organism unspecified,Disruption of external operation (surgical) wound,Alcohol withdrawal delirium,Alcoholic cardiomyopathy,Paralytic ileus,Blood in stool
Ulcerative ileocolitis,Pneumonia, organism NOS,Disrup-external op wound,Delirium tremens,Alcoholic cardiomyopathy,Paralytic ileus,Blood in stool
Admission Date:  [**2128-3-29**]     Discharge Date:  [**2128-4-15**]

Date of Birth:   [**2082-6-7**]     Sex:  M

Service:  SURGERY/GOLD

HISTORY OF PRESENT ILLNESS:  The patient is a 45 year old
male with a 24 year history of ulcerative colitis, who on
recent colonoscopy was found to have marked polypoid changes
in the transverse colon, making ongoing surveillance
impossible in terms of cancer prevention.  The patient's
gastroenterologist performed numerous biopsies in the region
with no dysplasia noted on pathology.  The ascending colon
and cecum were normal grossly as was the rectosigmoid portion
of the colon.  The patient's gastroenterologist also noted
some liver abnormalities on the patient's blood work in terms
of decreased platelet count and elevated AST.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  Aortic and mitral valve insufficiency.
3.  Alcoholism.
4.  Crohn's disease.

PAST SURGICAL HISTORY:  Appendectomy.

ALLERGIES:  No known drug allergies.

MEDICATIONS ON ADMISSION:
1.  Wellbutrin.
2.  Sulfasalazine.
3.  Benadryl.
4.  Vitamins.

PHYSICAL EXAMINATION:  The patient was afebrile with stable
vital signs.  He appeared reasonably healthy.  The patient
was hard of hearing.  The patient'a abdomen was notable for
an umbilical hernia.  The patient had a normal anus, anal
verge, sphincter tone and mucosa on rectal examination.
There was no palpable mass.  The patient had early
Dupuytren's contracture in both palms.  No cutaneous spiders
were noted.

HOSPITAL COURSE:  The patient was admitted to [**Hospital1 346**] on [**2128-3-29**], and taken to surgery
where he had a total colectomy performed with ileorectal
anastomosis. Surgery was performed without complications.
Please refer to the operative note for details.  The patient
was thereafter transferred to the surgical floor for
continued management.  Over the course of postoperative day
number one and postoperative day number two, the patient had
moderate and then increasing quantities of blood per rectum.
The patient's hematocrit was noted to drop from 30.5 to 25.0.
He ultimately required transfer to the Surgical Intensive
Care Unit for continued management for continued bleeding per
rectum as well as frequent need for transfusions.  By the
morning of postoperative day number two, the patient had
received six units of packed red blood cells as well as a
unit of platelets.  A decision was ultimately made to return
the patient to the operating room for suspected bleed at his
ileorectal anastomosis.  In the operating room, the patient
had a Hartmann's procedure performed with an end ileostomy
and rectal and abdominal washout.  The patient was thereafter
transferred to the Intensive Care Unit for continued
management.  The patient's Intensive Care Unit course was
notable for persistent low grade temperature that was
ultimately determined to be secondary to pneumonia.  The
patient was appropriately treated with the fever resolving.
During the course of the patient's nine day admission in the
Intensive Care Unit, the patient also developed significant
alcohol withdrawal symptoms.  The patient required sedation
and remained on a ventilator for much of his Intensive Care
Unit stay.  He was ultimately extubated on the night of
[**2128-4-8**].  The patient was also started on total parenteral
nutrition while in the Intensive Care Unit.  While in the
Intensive Care Unit, the patient also developed some erythema
of the proximal and distal portions of his midline abdominal
incision and was started on Kefzol.  The erythema ultimately
resolved with the therapy.  A small portion of the distal end
of his wound was opened and was managed with wet to dry
packings twice a day.  By the time of discharge, the patient
continued on wet to dry dressings twice a day and the wound
bed was looking healthy and granulating.  As part of the
workup of the patient's persistent fevers, the patient
underwent CAT scan of his abdomen on [**2128-4-7**].  The CAT scan
revealed a fluid collection with an enhancing rim adjacent to
the patient's rectal suture line.  This finding prompted the
scheduling of a pouchogram of the patient's rectal stump on
[**2128-4-8**].  The patient's stump was found not to have a leak
on this study.  The patient was transferred to a general
surgery floor on postoperative day number eleven/nine.  His
antibiotic therapy was discontinued.  As the gas offered from
his ostomy increased, the patient's diet was advanced.  His
nasogastric tube was also discontinued on postoperative day
thirteen/eleven.  The patient's total parenteral nutrition
was discontinued.  The patient was ultimately deemed stable
and ready for discharge on postoperative day number
seventeen/fifteen.  Prior to discharge, the patient was seen
by an addiction counselor.  The patient was to follow-up with
his primary care physician with arrangements made for further
addiction counseling.  The patient was also given the name
and number of [**Hospital1 69**] counselor
that he could contact.  The patient received teaching on the
management of his stoma while in house.

CONDITION ON DISCHARGE:  Stable.

MEDICATIONS ON DISCHARGE:
1.  Clonidine 0.2 mg once daily patch.
2.  Metoprolol 50 mg, 0.5 tablets twice a day.
3.  Percocet one to two tablets every four to six hours.
4.  Lorazepam 1 mg p.o. one half tablet every six hours as
needed.

FOLLOW-UP:   The patient was to follow-up with Dr.
[**Last Name (STitle) **] following discharge.  The patient was also to
follow-up with his primary care physician following
discharge.




                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 11126**]

Dictated By:[**Name8 (MD) 997**]

MEDQUIST36

D:  [**2128-4-15**]  18:22
T:  [**2128-4-17**]  15:19
JOB#:  [**Job Number 46122**]
{'Ulcerative (chronic) ileocolitis,Pneumonia, organism unspecified,Disruption of external operation (surgical) wound,Alcohol withdrawal delirium,Alcoholic cardiomyopathy,Paralytic ileus,Blood in stool'}


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 is a 45 year old
male with a 24 year history of ulcerative colitis, who on
recent colonoscopy was found to have marked polypoid changes
in the transverse colon, making ongoing surveillance
impossible in terms of cancer prevention.  The patient's
gastroenterologist performed numerous biopsies in the region
with no dysplasia noted on pathology.  The ascending colon
and cecum were normal grossly as was the rectosigmoid portion
of the colon.  The patient's gastroenterologist also noted
some liver abnormalities on the patient's blood work in terms
of decreased platelet count and elevated AST.

MEDICAL HISTORY: 1.  Hypertension.
2.  Aortic and mitral valve insufficiency.
3.  Alcoholism.
4.  Crohn's disease.

MEDICATION ON ADMISSION: 1.  Wellbutrin.
2.  Sulfasalazine.
3.  Benadryl.
4.  Vitamins.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Ulcerative (chronic) ileocolitis,Pneumonia, organism unspecified,Disruption of external operation (surgical) wound,Alcohol withdrawal delirium,Alcoholic cardiomyopathy,Paralytic ileus,Blood in stool'}
