CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 44-year-old
male with a past medical history significant for morbid
obesity and recurrent ventral hernia who presented to this
institution for elective ventral hernia repair with component
separation, mesh, and paniculectomy.

MEDICAL HISTORY: 1. Morbid obesity.  2.  Recurrent ventral hernia.  3.
   Obstructive sleep apnea.  4.  Hypertension.

MEDICATION ON ADMISSION: Aleve as needed for pain.

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Incisional ventral hernia with obstruction,Peritoneal adhesions (postoperative) (postinfection),Morbid obesity,Unspecified essential hypertension,Other diseases of pharynx, not elsewhere classified,Unspecified sleep apnea,Examination of participant in clinical trial
Obstr incisional hernia,Peritoneal adhesions,Morbid obesity,Hypertension NOS,Disease of pharynx NEC,Sleep apnea NOS,Exam-clincal trial
Admission Date: [**2153-7-3**]        Discharge Date: [**2153-7-17**]

Date of Birth:  [**2109-2-9**]        Sex:  M

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


HISTORY OF PRESENT ILLNESS:  The patient is a 44-year-old
male with a past medical history significant for morbid
obesity and recurrent ventral hernia who presented to this
institution for elective ventral hernia repair with component
separation, mesh, and paniculectomy.

PAST MEDICAL HISTORY:
1. Morbid obesity.  2.  Recurrent ventral hernia.  3.
   Obstructive sleep apnea.  4.  Hypertension.


PAST SURGICAL HISTORY:
1. Ventral hernia repair with mesh times four.  2. Ruptured
   thoracic aorta injury secondary to a motor vehicle
   collision in [**2138**] status post repair.  3.  Status post
   pelvic fracture.


MEDICATIONS ON ADMISSION:  Aleve as needed for pain.

ALLERGIES:  NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAMINATION:  Vital signs:  Temperature 96.1, pulse
74, blood pressure 133/58, respirations 20, oxygen saturation
97 percent on room air.  General:  The patient was an obese,
pleasant, Caucasian male who appeared his stated age.  He was
in no apparent distress.  HEENT:  Oropharynx clear with moist
mucous membranes.  Neck supple without lymphadenopathy.
Heart:  Regular rate and rhythm.  Lungs:  Clear to
auscultation bilaterally.  Abdomen:  Soft, nontender, and
nondistended with a large supraumbilical abdominal hernia.
Extremities:  Warm without clubbing, cyanosis, or edema.

HOSPITAL COURSE:  Given the patient's morbid obesity with a
preoperative weight of 350 lbs and his failed ventral hernia
repairs in the past, the patient was taken to the Operating
Room on [**2153-7-3**], where he underwent a ventral hernia
repair with component separation, mesh placement, lysis of
adhesions, and paniculectomy.  The patient tolerated the
procedure well with an estimated blood loss of 300 cc.

The patient received 7 L of fluid intraoperative, including
Albumin and Hespan.  He remained intubated and paralyzed and
was transferred to the Surgical Intensive Care Unit
postoperatively in stable condition.

The patient was given 1 U packed red blood cells on
postoperative day 1 for a hematocrit of 24.1.  He also had a
right subclavian central venous line placed.  A nasogastric
tube was present along with two [**Location (un) 1661**]-[**Location (un) 1662**] drains and a
Foley catheter.

The patient was kept intubated and paralyzed for fear of
developing an abdominal compartment syndrome.  He was treated
with Kefzol prophylactically.

The posttransfusion hematocrit was 28.5 percent.  He was
given an additional 2 U packed red blood cells on
postoperative day 2.  The patient remained persistently
tachycardiac postoperatively and was treated with beta-
blockade.  His hematocrit remained stable.

His paralysis was weaned on postoperative day 4.  At this
time, he was started on a Lasix drip to immobilize his
intraoperative and postoperative fluid gains.  He was also
treated with tube feedings until such time that he could be
extubated and fed by mouth.

The patient did spike a temperature to 102F.  Given the
concern for intra-abdominal fluid collection, a CT scan was
obtained.  This study did not find any evidence of leak or
fluid collection.

At this time, the patient was tolerating his tube feeds at
goal.  He remained on his Kefzol prophylaxis and was diuresed
with Lasix 40 mg twice daily.

Given the patient's body habitus and concern for pulmonary
embolism, a CT angiogram of the chest was obtained.  This
study was negative.

On postoperative day 10, the patient was extubated.  His NG
tube was then removed, and he was started on sips of clear
liquids.  His diet was then advanced, and he was tolerating a
regular diet on postoperative day 12.  At this time, the
patient was seen by Physical Therapy for assistance with
ambulation.  The left [**Location (un) 1661**]-[**Location (un) 1662**] drain was removed on
postoperative day 13.  At this time, the Kefzol was
discontinued.

On postoperative day 14, the patient was transferred to the
floor after remaining in stable condition for greater than 48
hours.  His Foley catheter was then removed, and he was
comfortable, ambulating with assistance, and voiding
independently.

At this time, after the abdominal staples were removed, the
patient was discharged to rehabilitation with one remaining
[**Location (un) 1661**]-[**Location (un) 1662**] drain in place in stable condition.

CONDITION ON DISCHARGE:  Good.

DISPOSITION:  The patient was discharged to rehabilitation.

DISCHARGE DIAGNOSIS:  Morbid obesity.

Obstructive sleep apnea.

Hypertension.

Recurrent ventral hernia.

Status post ventral hernia repair with mesh and component
separation.

Status post paniculectomy.

Status post repair of ruptured thoracic aorta injury.

DISCHARGE MEDICATIONS:
1. Heparin 5000 U subcutaneously q.8 hours while at
   rehabilitation.
2. Metoprolol 37.5 mg p.o. b.i.d.
3. Percocet 5/325 [**2-2**] tab p.o. q.4-6 hours p.r.n. pain.
4. Colace 100 mg p.o. b.i.d.


FOLLOW UP:  The patient was instructed to follow-up with Dr.
[**First Name (STitle) **] from the Plastic Surgery Department in approximately
two weeks.  He was instructed to leave the [**Location (un) 1661**]-[**Location (un) 1662**]
drain in place until that time.  The patient will be seeing
Dr. [**Last Name (STitle) **] in the office in approximately two weeks as
well.  He was instructed to follow-up sooner if he developed
fevers greater than 101.#5 F, severe abdominal pain,
vomiting, or any other questions or concerns.




                        [**First Name11 (Name Pattern1) 333**] [**Last Name (NamePattern4) 366**], [**MD Number(1) 367**]

Dictated By:[**Last Name (NamePattern1) 22791**]
MEDQUIST36
D:  [**2153-7-17**] 11:34:03
T:  [**2153-7-17**] 12:01:22
Job#:  [**Job Number **]


Admission Date: [**2153-7-3**]        Discharge Date: [**2153-7-19**]

Date of Birth:  [**2109-2-9**]        Sex:  M

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


ADDENDUM:  The patient was anticipating discharge on [**2153-7-17**].
However, due to bed unavailability, the patient remained
hospitalized until a rehabilitation facility had a bed
opening.  His additional two days involved ongoing physical
therapy and [**First Name8 (NamePattern2) 1661**] [**Last Name (NamePattern1) 1662**] drain care as needed.  He was
tolerating regular diet, moving his bowels and ambulating
without difficulty.  Once the bed was available the patient
was discharge in stable condition without difficulty.



                        [**First Name11 (Name Pattern1) 333**] [**Last Name (NamePattern4) 366**], [**MD Number(1) 367**]

Dictated By:[**Last Name (NamePattern1) 22791**]
MEDQUIST36
D:  [**2153-7-19**] 10:02:59
T:  [**2153-7-19**] 10:19:59
Job#:  [**Job Number **]
{'Incisional ventral hernia with obstruction,Peritoneal adhesions (postoperative) (postinfection),Morbid obesity,Unspecified essential hypertension,Other diseases of pharynx, not elsewhere classified,Unspecified sleep apnea,Examination of participant in clinical trial'}


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 44-year-old
male with a past medical history significant for morbid
obesity and recurrent ventral hernia who presented to this
institution for elective ventral hernia repair with component
separation, mesh, and paniculectomy.

MEDICAL HISTORY: 1. Morbid obesity.  2.  Recurrent ventral hernia.  3.
   Obstructive sleep apnea.  4.  Hypertension.

MEDICATION ON ADMISSION: Aleve as needed for pain.

ALLERGIES: NO KNOWN DRUG ALLERGIES.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Incisional ventral hernia with obstruction,Peritoneal adhesions (postoperative) (postinfection),Morbid obesity,Unspecified essential hypertension,Other diseases of pharynx, not elsewhere classified,Unspecified sleep apnea,Examination of participant in clinical trial'}
