CHIEF COMPLAINT: abdominal pain

PRESENT ILLNESS: Patient is a 45F without significant PMH who presents with a 1
day h/o worsening abdominal pain. The patient states that the
pain began suddenly when she awoke this morning and attempted to
get out of bed. At the time, she noted a "tearing" sensation in
her abdominal wall. This pain has gotten progressively worse
since then. She has also noted increasing abdoiminal distention.
She presented to [**Hospital1 **] [**Location (un) 620**], where she was found to have
bilateral rectus wall hematomas. She is now transferred for
further care.

MEDICAL HISTORY: denies

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: In the ED:
General: awake and alert
CV: RRR
Lungs: CTA bilaterally
Abdomen: soft, distended, (+) tenderness RLQ/LLQ, no
rebound/guarding, hypoactive BS

FAMILY HISTORY: nc

SOCIAL HISTORY: denies t/e/d
Nontraumatic hematoma of soft tissue
Nontrauma hema soft tiss
Admission Date:  [**2178-3-24**]              Discharge Date:   [**2178-3-26**]

Date of Birth:  [**2132-9-8**]             Sex:   F

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 2836**]
Chief Complaint:
abdominal pain

Major Surgical or Invasive Procedure:
none


History of Present Illness:
Patient is a 45F without significant PMH who presents with a 1
day h/o worsening abdominal pain. The patient states that the
pain began suddenly when she awoke this morning and attempted to
get out of bed. At the time, she noted a "tearing" sensation in
her abdominal wall. This pain has gotten progressively worse
since then. She has also noted increasing abdoiminal distention.
She presented to [**Hospital1 **] [**Location (un) 620**], where she was found to have
bilateral rectus wall hematomas. She is now transferred for
further care.


Past Medical History:
denies

Social History:
denies t/e/d

Family History:
nc

Physical Exam:
In the ED:
General: awake and alert
CV: RRR
Lungs: CTA bilaterally
Abdomen: soft, distended, (+) tenderness RLQ/LLQ, no
rebound/guarding, hypoactive BS


Pertinent Results:
CTAP: bilateral rectus sheath hematomas, R>L, with evidence of
active blush bilaterallly

[**2178-3-23**] 11:58PM   WBC-6.4 RBC-2.73* HGB-9.0* HCT-26.7* MCV-98
MCH-33.0* MCHC-33.8 RDW-13.2
[**2178-3-23**] 11:58PM   PLT COUNT-198
[**2178-3-23**] 11:58PM   PT-10.8 PTT-27.2 INR(PT)-0.9
[**2178-3-24**] 04:46PM   HCT-29.2*

Brief Hospital Course:
Mrs. [**Known lastname 4886**] was admitted on transfer from [**Hospital1 **] [**Location (un) 620**] and
received one unit of packed red blood cells. She was observed in
the ICU where she remained stable. A hematology/oncology consult
was obtained and they found no obvious reason for her
spontaneous hematoma and suggested follow up imaging after
hematoma resolution to exclude some type of vascular or
anatomical anomaly that could have predisposed her to this
problem. She had a bleeding scan that showed no active
extravasation. She was observed in the ICU and then transferred
to the floor as she was hemodynamically stable and her
hematocrits remained stable. Her diet was advanced and she is
being discharged afebrile with stable vital signs, tolerating an
oral diet with pain well controlled. She will follow up with Dr.
[**First Name (STitle) **] in clinic.

Medications on Admission:
none

Discharge Medications:
1. Hydrocodone-Acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO
Q6H (every 6 hours) as needed for pain.
Disp:*14 Tablet(s)* Refills:*0*
2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*


Discharge Disposition:
Home

Discharge Diagnosis:
spontaneous rectus sheath hematoma


Discharge Condition:
Mental Status:Clear and coherent
Level of Consciousness:Alert and interactive
Activity Status:Ambulatory - Independent


Discharge Instructions:
*You experience new chest pain, pressure, squeezing or
tightness.
*New or worsening cough, shortness of breath, or wheeze.
*If you are vomiting and cannot keep down fluids or your
medications.
*You are getting dehydrated due to continued vomiting, diarrhea,
or other reasons. Signs of dehydration include dry mouth, rapid
heartbeat, or feeling dizzy or faint when standing.
*You see blood or dark/black material when you vomit or have a
bowel movement.
*You experience burning when you urinate, have blood in your
urine, or experience a discharge.
*Your pain is not improving within 8-12 hours or is not gone
within 24 hours. Call or return immediately if your pain is
getting worse or changes location or moving to your chest or
back.
*You have shaking chills, or fever greater than 101.5 degrees
Fahrenheit or 38 degrees Celsius.
*Any change in your symptoms, or any new symptoms that concern
you.

General Discharge Instructions:

Please resume all regular home medications , unless specifically
advised not to take a particular medication. Also, please take
any new medications as prescribed.

Please get plenty of rest, continue to ambulate several times
per day, and drink adequate amounts of fluids. Avoid lifting
weights greater than [**6-22**] lbs until you follow-up with your
surgeon, who will instruct you further regarding activity
restrictions.

Avoid driving or operating heavy machinery while taking pain
medications.

Please follow-up with your surgeon and Primary Care Provider
(PCP) as advised.

Followup Instructions:
Please call Dr.[**Name (NI) 5067**] office at ([**Telephone/Fax (1) 99618**] to schedule a
follow up appointment.

You will need follow up imaging after resolution of the hematoma
to evaluate for an anatomical reason for your spontaneous
hematoma.
{'Nontraumatic hematoma of soft tissue'}


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: Patient is a 45F without significant PMH who presents with a 1
day h/o worsening abdominal pain. The patient states that the
pain began suddenly when she awoke this morning and attempted to
get out of bed. At the time, she noted a "tearing" sensation in
her abdominal wall. This pain has gotten progressively worse
since then. She has also noted increasing abdoiminal distention.
She presented to [**Hospital1 **] [**Location (un) 620**], where she was found to have
bilateral rectus wall hematomas. She is now transferred for
further care.

MEDICAL HISTORY: denies

MEDICATION ON ADMISSION: none

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: In the ED:
General: awake and alert
CV: RRR
Lungs: CTA bilaterally
Abdomen: soft, distended, (+) tenderness RLQ/LLQ, no
rebound/guarding, hypoactive BS

FAMILY HISTORY: nc

SOCIAL HISTORY: denies t/e/d 

### Response:
{'Nontraumatic hematoma of soft tissue'}
