CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is an 82 year old
male, who underwent a screening endoscopy and colonoscopy on
[**2188-7-18**].  During the procedure, polypectomy was performed on
a polyp seen in the left ascending colon.  The patient was
discharged home and on the morning of admission, developed
brisk bright blood per rectum and syncope when he stood up
from his bed.  He presented to the Emergency Department at
which time he was found to be hypotensive with a systolic
blood pressure in the 60's. He was immediately resuscitated
for hypovolemic shock.

MEDICAL HISTORY: Significant for prostate cancer, basal
cell carcinoma, colonic polyp, hiatal hernia,
gastroesophageal reflux disease.

MEDICATION ON ADMISSION: None.

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: There is no history of tobacco or ETOH use.
Hemorrhage complicating a procedure,Other shock without mention of trauma,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Diaphragmatic hernia without mention of obstruction or gangrene,Esophageal reflux,Personal history of malignant neoplasm of prostate
Hemorrhage complic proc,Shock w/o trauma NEC,Abn react-surg proc NEC,Diaphragmatic hernia,Esophageal reflux,Hx-prostatic malignancy
Admission Date:  [**2188-7-19**]       Discharge Date:  [**2188-7-22**]


Service:

HISTORY OF PRESENT ILLNESS:  The patient is an 82 year old
male, who underwent a screening endoscopy and colonoscopy on
[**2188-7-18**].  During the procedure, polypectomy was performed on
a polyp seen in the left ascending colon.  The patient was
discharged home and on the morning of admission, developed
brisk bright blood per rectum and syncope when he stood up
from his bed.  He presented to the Emergency Department at
which time he was found to be hypotensive with a systolic
blood pressure in the 60's. He was immediately resuscitated
for hypovolemic shock.

The patient also underwent nasotracheal intubation in the
Emergency Room for airway protection.

PAST MEDICAL HISTORY:  Significant for prostate cancer, basal
cell carcinoma, colonic polyp, hiatal hernia,
gastroesophageal reflux disease.

PAST SURGICAL HISTORY: Significant for bilateral inguinal
hernia repairs.  Status post XRT for prostate cancer and a
previous transurethral resection of prostate.

MEDICATIONS ON ADMISSION:  None.

ALLERGIES:  None.

SOCIAL HISTORY:   There is no history of tobacco or ETOH use.

PHYSICAL EXAMINATION:  The patient was intubated and sedated.
Heart rate was 90; blood pressure was 124/70.  Chest is
clear. His heart is regular.  His abdomen is nontender and
nondistended.  There is bright red blood per rectum.
Bilateral lower extremity edema.

LABORATORY DATA:  Initial laboratory results included a white
count of 10 and hematocrit of 22 which, after resuscitation,
was repeated and found to be 30; platelet of 343.  BUN of 18;
creatinine of 0.9.  INR of 1.0.

HOSPITAL COURSE:  After undergoing the abovementioned
maneuvers in the Emergency Department, the patient was
transferred to the angio suite to undergo angiography.  Prior
to angiography, the patient had a nasogastric tube lavage of
the upper gastrointestinal tract and was found to have no
evidence of bleeding.  The patient underwent angiography of
the superior mesenteric artery and inferior mesenteric artery
and there was no active extravasation seen at that time.  He
tolerated this procedure well.  He was then transferred to
the Intensive Care Unit under the care of the surgical team.

Overnight, over his first night, the patient was transfused
for a total of six units of packed red blood cells and two
units of FFP.  He remained hemodynamically stable and was
maintained on a ventilator overnight.

On hospital day number two, the patient was weaned and
extubated without incident.  There were no further episodes
of bleeding and the patient's hematocrit remained stable at
30.  The patient continued to do well with no evidence of
active bleeding.

On hospital day number three, the diet was advanced and the
patient was transferred to the floor.

The patient has continued to do well and has been followed by
the gastroenterology service.  They will follow him as an
outpatient. His hematocrit remained stable and the patient is
now ready for discharge to home.

DISCHARGE DIAGNOSES:
Acute lower gastrointestinal bleed, presumed site of recent
     polypectomy, Hemorrhagic shock, requiring blood
transfusion
     History of prostate cancer.
Status post XRT and transurethral resection of prostate.
History of basal cell carcinoma.
Gastroesophageal reflux disease.

MEDICATIONS:
Protonic 40 mg p.o. q. day.

The patient will follow-up with Dr. [**Last Name (STitle) 6081**] in the
gastrointestinal clinic in one week and will call for an
appointment.  The patient will also to continue to follow-up
with his primary care physician as appropriate.

CONDITION ON DISCHARGE:  The patient is tolerating a diet,
with no evidence of active bleeding. The patient is
instructed to call should he become symptomatic once again.

                            [**Name6 (MD) 843**] [**Name8 (MD) 844**], M.D.  [**MD Number(1) 845**]

Dictated By:  [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D.
MEDQUIST36
D:  [**2188-7-21**]  05:44
T:  [**2188-7-21**]  17:43
JOB#:  [**Job Number 6082**]
{'Hemorrhage complicating a procedure,Other shock without mention of trauma,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Diaphragmatic hernia without mention of obstruction or gangrene,Esophageal reflux,Personal history of malignant neoplasm of prostate'}


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 an 82 year old
male, who underwent a screening endoscopy and colonoscopy on
[**2188-7-18**].  During the procedure, polypectomy was performed on
a polyp seen in the left ascending colon.  The patient was
discharged home and on the morning of admission, developed
brisk bright blood per rectum and syncope when he stood up
from his bed.  He presented to the Emergency Department at
which time he was found to be hypotensive with a systolic
blood pressure in the 60's. He was immediately resuscitated
for hypovolemic shock.

MEDICAL HISTORY: Significant for prostate cancer, basal
cell carcinoma, colonic polyp, hiatal hernia,
gastroesophageal reflux disease.

MEDICATION ON ADMISSION: None.

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: There is no history of tobacco or ETOH use. 

### Response:
{'Hemorrhage complicating a procedure,Other shock without mention of trauma,Other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation,Diaphragmatic hernia without mention of obstruction or gangrene,Esophageal reflux,Personal history of malignant neoplasm of prostate'}
