CHIEF COMPLAINT: severe pancreatitis
ARDS requiring intubation

PRESENT ILLNESS: 56 y/o transferred from [**Hospital 1562**] Hosp via Med Flight for
hemorrhagic pancreatitis & respiratory failure. Pt originally
admitted to [**Hospital 1562**] Hosp on [**2185-6-2**] from [**Location (un) 3244**] Detox center
following a three week history of binge drinking with epigastric
pain, N/V for 2 days PTA. Dx'd with severe pancreatitis with
hemmorrhagic component. (On coumadin for Afib) requiring 6 u
PRBCs, 6 FFP and plts. Pt intubated at OLH for airway
protection. On [**6-7**] pt transferred to [**Hospital1 18**] for continued care.

MEDICAL HISTORY: depression
EtOh at detox
A fib
HTN

MEDICATION ON ADMISSION: Coumadin 5', Digoxin o.125', Lisinopril 40', Librium prn, Librax
0.5',
Effexor XR 150', Lipid 600'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On admission to [**Hospital1 18**] SICU:
Patient Intubated and sedated
Coarse bilateral BS
RRR
Abdomen soft with rebound and guarding
Extremeties, Trace Edema.

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: Married
Hx ETOH abuse (20 oz/day per pt report)
Denies tobacco, IVDA
Acute pancreatitis,Acute kidney failure, unspecified,Pulmonary collapse,Alcohol withdrawal,Congestive heart failure, unspecified,Unspecified essential hypertension,Acute alcoholic intoxication in alcoholism, continuous,Diverticulum of esophagus, acquired,Atrial fibrillation,Other specified disorders of pancreatic internal secretion
Acute pancreatitis,Acute kidney failure NOS,Pulmonary collapse,Alcohol withdrawal,CHF NOS,Hypertension NOS,Ac alcohol intox-contin,Acq esophag diverticulum,Atrial fibrillation,Pancreatic disorder NEC
Admission Date:  [**2185-6-7**]              Discharge Date:   [**2185-6-17**]

Date of Birth:  [**2128-9-11**]             Sex:   M

Service: SURGERY

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 668**]
Chief Complaint:
severe pancreatitis
ARDS requiring intubation

Major Surgical or Invasive Procedure:
None

History of Present Illness:
56 y/o transferred from [**Hospital 1562**] Hosp via Med Flight for
hemorrhagic pancreatitis & respiratory failure. Pt originally
admitted to [**Hospital 1562**] Hosp on [**2185-6-2**] from [**Location (un) 3244**] Detox center
following a three week history of binge drinking with epigastric
pain, N/V for 2 days PTA. Dx'd with severe pancreatitis with
hemmorrhagic component. (On coumadin for Afib) requiring 6 u
PRBCs, 6 FFP and plts. Pt intubated at OLH for airway
protection. On [**6-7**] pt transferred to [**Hospital1 18**] for continued care.


Past Medical History:
depression
EtOh at detox
A fib
HTN

Social History:
Married
Hx ETOH abuse (20 oz/day per pt report)
Denies tobacco, IVDA

Family History:
non-contributory

Physical Exam:
On admission to [**Hospital1 18**] SICU:
Patient Intubated and sedated
Coarse bilateral BS
RRR
Abdomen soft with rebound and guarding
Extremeties, Trace Edema.

Now on [**6-17**]
VSS 98.3, 59 112/64 18 100%RA   FSBS 66-231
NAD, RRR, Lungs CTA bilaterally,
Abd soft, NT, ND with + BS
Extremeties, no edema noted
Diet advancing to regular, tolerating well

Pertinent Results:
Initial Amylase/Lipase from [**2185-6-3**]   [**Telephone/Fax (1) 67692**]

Labs from [**2185-6-7**] 06:16PM
ART PO2-82* PCO2-49* PH-7.35 TOTAL CO2-28 BASE XS-0
GLUCOSE-121* LACTATE-0.9
freeCa-1.12
GLUCOSE-123* UREA N-28* CREAT-1.9* SODIUM-149* POTASSIUM-3.9
CHLORIDE-114* TOTAL CO2-26 ANION GAP-13
ALT(SGPT)-27 AST(SGOT)-68* LD(LDH)-1848* ALK PHOS-177* TOT
BILI-1.8*
AMYLASE-105*  LIPASE-254*
ALBUMIN-2.7* CALCIUM-7.7* PHOSPHATE-2.7 MAGNESIUM-2.2
WBC-6.5 RBC-3.43* HGB-10.7* HCT-31.1* MCV-91 MCH-31.3 MCHC-34.4
RDW-15.8*
NEUTS-69 BANDS-2 LYMPHS-11* MONOS-13* EOS-3 BASOS-0 ATYPS-0
METAS-2*
PLT COUNT-172
PT-18.8* PTT-25.8 INR(PT)-1.8*  FIBRINOGEN-1224*

CT: [**2185-6-9**]  severe pancreatitis w/lg amt fluid/stranding around
the pancreas extending into L paracolic gutter, L ant/post
perirenal space, free fluid in the pelvis,

Labs from [**2185-6-17**]
Na 141 K 4.2 Cl 108  Co2 20  BUN 26  Creat 1.3  glucose 103
Ca: 9.3 Mg: 1.9 P: 4.2
AST: 34  ALT: 47 AP: 127 Tbili: 0.8 Alb: 3.9
[**Doctor First Name **]: 137 Lip: 430
WBC 7.5  Hgb: 11.7  Hct 35.5   Plt 638
PT: 14.1  PTT: 27.8  INR: 1.3


Brief Hospital Course:
57 y/o male with known ETOH abuse, HTN, hyperlipidemia, AFib on
Coumadin/digoxin transferred from [**Hospital 1562**] Hosp after 5 day
admission for hemorrhagic pancreatitis and ARDS. On arrival to
SICU pt was intubated and sedated and was receiving TPN,
imipenem (7 day course). No pressor support. During the one week
ICU course, pt was slowly weaned from vent support, started on
TF and diuresed. Pt did have some renal failure during the
course, but this has since resolved, with current creat at
probable baseline of 1.3. CT showed evidence of severe
pancreatitis with a large amount of fluid and stranding
surrounding the pancreas, extending into the left paracolic
gutter, left anterior and posterior perirenal space, and right
perirenal space. Free fluid is seen extending down into the
pelvis. Assessment of pancreas enhancement is limited, but
appears relatively uniform. No definite thrombus is identified
within the portal and splenic veins. There were also moderate to
large bilateral pleural effusions with associated atelectasis.
Extubation was on [**6-12**], and patient continued to improve and was
transferred to the regular floor on [**6-15**]. Originally pt had a
1:1 sitter which was d/c'd on [**6-16**]. Pt has worked with PT and
has advanced diet. It was felt that he did not require physical
rehab. He required outpatient counseling/work at detox center.
He was discharged home on insulin. He was instructed in how to
check his blood sugars as well as self administer insulin.
He was advised to follow up with PCP as well as an outpatient
gastroenterologist.


Medications on Admission:
Coumadin 5', Digoxin o.125', Lisinopril 40', Librium prn, Librax
0.5',
Effexor XR 150', Lipid 600'

Discharge Medications:
1. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
Disp:*30 Tablet(s)* Refills:*0*
2. Protonix 40 mg Tablet, Delayed Release (E.C.) Sig: One (1)
Tablet, Delayed Release (E.C.) PO once a day.
Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*1*
3. Insulin Glulisine 100 unit/mL Solution Sig: Ten (10) ubits
Subcutaneous once a day.
Disp:*1 * Refills:*2*
4. Humalog 100 unit/mL Solution Sig: follow sliding scale
Subcutaneous four times a day.
Disp:*1 * Refills:*2*
5. syringes
1 box
refill:2
6. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*2*


Discharge Disposition:
Home With Service

Facility:
[**Hospital3 **] home health

Discharge Diagnosis:
pancreatitis: resolving


Discharge Condition:
good


Discharge Instructions:
Call [**Telephone/Fax (1) 67693**] with increasing abdominal or back pain,
fever,chills, nausea, vomiting or diarrhea.

Followup Instructions:
Call Primary Care physician for appointment in 2 weeks for
management of blood pressure medications



Completed by:[**2185-7-1**]
{'Acute pancreatitis,Acute kidney failure, unspecified,Pulmonary collapse,Alcohol withdrawal,Congestive heart failure, unspecified,Unspecified essential hypertension,Acute alcoholic intoxication in alcoholism, continuous,Diverticulum of esophagus, acquired,Atrial fibrillation,Other specified disorders of pancreatic internal secretion'}


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: severe pancreatitis
ARDS requiring intubation

PRESENT ILLNESS: 56 y/o transferred from [**Hospital 1562**] Hosp via Med Flight for
hemorrhagic pancreatitis & respiratory failure. Pt originally
admitted to [**Hospital 1562**] Hosp on [**2185-6-2**] from [**Location (un) 3244**] Detox center
following a three week history of binge drinking with epigastric
pain, N/V for 2 days PTA. Dx'd with severe pancreatitis with
hemmorrhagic component. (On coumadin for Afib) requiring 6 u
PRBCs, 6 FFP and plts. Pt intubated at OLH for airway
protection. On [**6-7**] pt transferred to [**Hospital1 18**] for continued care.

MEDICAL HISTORY: depression
EtOh at detox
A fib
HTN

MEDICATION ON ADMISSION: Coumadin 5', Digoxin o.125', Lisinopril 40', Librium prn, Librax
0.5',
Effexor XR 150', Lipid 600'

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: On admission to [**Hospital1 18**] SICU:
Patient Intubated and sedated
Coarse bilateral BS
RRR
Abdomen soft with rebound and guarding
Extremeties, Trace Edema.

FAMILY HISTORY: non-contributory

SOCIAL HISTORY: Married
Hx ETOH abuse (20 oz/day per pt report)
Denies tobacco, IVDA 

### Response:
{'Acute pancreatitis,Acute kidney failure, unspecified,Pulmonary collapse,Alcohol withdrawal,Congestive heart failure, unspecified,Unspecified essential hypertension,Acute alcoholic intoxication in alcoholism, continuous,Diverticulum of esophagus, acquired,Atrial fibrillation,Other specified disorders of pancreatic internal secretion'}
