CHIEF COMPLAINT: Abdominal pain

PRESENT ILLNESS: [**Age over 90 **] year old male with history of coronary artery disease and
atrial fibrillation was admitted on [**2173-11-12**] for acute abdominal
pain which occured shortly after eating. Pain was sharp and
non-radiating, localized in the right upper quadrant.  His LFTs,
alk phos, and bilirubin were elevated.  He had never experienced
pain similar to this in the past. Mr. [**Known lastname 98584**] [**Last Name (Titles) 15797**] nausea,
vomiting and chest pain.  He was admitted to the surgical team
for further care and monitoring.

MEDICAL HISTORY: 1. Coronary artery disease status post CABG in [**2161**].
2. Atrial fibrillation on Coumadin.
3. Vestibular schwannoma treated with chemotherapy at [**Hospital 14852**].
4. History of a hiatal hernia.
5. Total radical resection of the prostate.
6. Bilateral inguinal hernia repairs

MEDICATION ON ADMISSION: plavix, trazadone, protonix, lopressor, ASA, coumadin,
isosorbide, colace, senna

ALLERGIES: Procardia

PHYSICAL EXAM: VIT: Temp 99.6 HR 84 sinus BP 137/62 RR 30 O2 sat 95% on 3L face
mask
EOMI,NC/AT, PERRL, anicteric
CTAB
RRR III/VI systolic murmur
+BS, distended, tympanic, RUQ TTP
no edema, 2+ pedal pulses
foley in place

FAMILY HISTORY: none

SOCIAL HISTORY: The patient denies any tobacco use, but admits to occasional
alcohol use. He lives alone and is retired.
Calculus of bile duct with acute cholecystitis, without mention of obstruction,Atrial fibrillation,Cholangitis,Long-term (current) use of anticoagulants,Aortocoronary bypass status
Choledocholith/ac gb inf,Atrial fibrillation,Cholangitis,Long-term use anticoagul,Aortocoronary bypass
Admission Date:  [**2173-11-12**]              Discharge Date:   [**2173-11-19**]


Service: SURGERY

Allergies:
Procardia

Attending:[**First Name3 (LF) 1481**]
Chief Complaint:
Abdominal pain

Major Surgical or Invasive Procedure:
ERCP with plastic stent placement


History of Present Illness:
[**Age over 90 **] year old male with history of coronary artery disease and
atrial fibrillation was admitted on [**2173-11-12**] for acute abdominal
pain which occured shortly after eating. Pain was sharp and
non-radiating, localized in the right upper quadrant.  His LFTs,
alk phos, and bilirubin were elevated.  He had never experienced
pain similar to this in the past. Mr. [**Known lastname 98584**] [**Last Name (Titles) 15797**] nausea,
vomiting and chest pain.  He was admitted to the surgical team
for further care and monitoring.


Past Medical History:
1. Coronary artery disease status post CABG in [**2161**].
2. Atrial fibrillation on Coumadin.
3. Vestibular schwannoma treated with chemotherapy at [**Hospital 14852**].
4. History of a hiatal hernia.
5. Total radical resection of the prostate.
6. Bilateral inguinal hernia repairs

Social History:
The patient denies any tobacco use, but admits to occasional
alcohol use. He lives alone and is retired.


Family History:
none

Physical Exam:
VIT: Temp 99.6 HR 84 sinus BP 137/62 RR 30 O2 sat 95% on 3L face
mask
EOMI,NC/AT, PERRL, anicteric
CTAB
RRR III/VI systolic murmur
+BS, distended, tympanic, RUQ TTP
no edema, 2+ pedal pulses
foley in place

Pertinent Results:
[**2173-11-12**]: WBC-6.1 RBC-4.90 Hgb-15.7 Hct-41.7 MCV-85 MCH-31.9
MCHC-37.5* RDW-13.8 Plt Ct-149*
PT-21.9* PTT-32.9 INR(PT)-3.4 Plt Ct-149*
Glucose-136* UreaN-21* Creat-1.1 Na-138 K-4.4 Cl-99 HCO3-26
AnGap-17
ALT-281* AST-464* LD(LDH)-694* AlkPhos-179* TotBili-3.2*
Lipase-239*
Calcium-9.9 Phos-3.2 Mg-2.1
Lactate-2.7*
[**2173-11-16**]: WBC-3.9* RBC-3.96* Hgb-12.7* Hct-34.3* MCV-87
MCH-32.1* MCHC-37.1* RDW-13.6 Plt Ct-168
[**2173-11-18**]: PT-15.0* PTT-29.9 INR(PT)-1.5
K-4.0
[**2173-11-17**]: TotBili-1.4
[**2173-11-16**]: Lipase-105*
[**2173-11-18**]: Calcium-8.4 Phos-2.4* Mg-1.8

Brief Hospital Course:
Mr. [**Known lastname 98584**] developed tachypnea in the ED and his O2 sats
were in the high 80's to low 90's.  He was afebrile and CXR
showed no evidence of consolidation.  He was given lasix and
placed on oxygen.  His sats improved and an abdominal CT was
ordered which showed evidence of cholecystitis.  GI was
consulted and ERCP was performed the same day.  He required 4
units FFP to correct his INR prior to procedure.  There were no
stones in his bile duct and a biliary stent was placed.  He was
trasferred to the ICU for further monitoring due to his troubles
maintaining his O2 saturation.  By hospital day 3, his sats
improved and he was transferred to the floor.  His LFTs trended
down and his symptoms improved.  He was started on a light diet
and will be discharged to [**Hospital 100**] rehab when a bed is available.
INR will be monitored by PCP.  [**Name10 (NameIs) **] has been instructed to follow
up with Dr. [**Last Name (STitle) 10356**] in [**1-15**] weeks. He will also f/u with GI for
a repeat ERCP and sphincterotomy in 2 weeks.

Medications on Admission:
plavix, trazadone, protonix, lopressor, ASA, coumadin,
isosorbide, colace, senna

Discharge Medications:
1. Amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

2. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q6H (every 6 hours) as needed.
3. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
4. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2
times a day).
5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed.
6. Trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as
needed.
7. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
8. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
10. Warfarin 2 mg Tablet Sig: One (1) Tablet PO HS (at bedtime):
Please adjust dose based on daily INR results. Goal INR [**1-14**].
11. Levofloxacin 750 mg Tablet Sig: One (1) Tablet PO once a day
for 10 days.
12. Flagyl 500 mg Tablet Sig: One (1) Tablet PO three times a
day for 10 days.


Discharge Disposition:
Extended Care

Facility:
[**Hospital6 459**] for the Aged - Acute Rehab

Discharge Diagnosis:
Cholecystitis


Discharge Condition:
Good


Discharge Instructions:
Please call your doctor or go to the ER if you experience any of
the following: high fevers >101.5, severe pain uncontrolled by
your medication, worsening nausea/emesis. Will need daily INR
checks until therapeutic on a coumadin regimen. Will also need
to hold ASA, plavix, and coumadin prior to ERCP. Please follow
GI recommendations when appointment is made in regards to
holding those medications.

Followup Instructions:
Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 28258**], MD Phone:[**Telephone/Fax (1) 1387**] Date/Time:
[**2173-12-7**] 1:50
Dr. [**Last Name (STitle) **] (for repeat ERCP) - Please call [**Telephone/Fax (1) 2422**] or
[**Telephone/Fax (1) 2799**] for an appointment. Will need repeat ERCP in 2
weeks.
{'Calculus of bile duct with acute cholecystitis, without mention of obstruction,Atrial fibrillation,Cholangitis,Long-term (current) use of anticoagulants,Aortocoronary bypass status'}


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: [**Age over 90 **] year old male with history of coronary artery disease and
atrial fibrillation was admitted on [**2173-11-12**] for acute abdominal
pain which occured shortly after eating. Pain was sharp and
non-radiating, localized in the right upper quadrant.  His LFTs,
alk phos, and bilirubin were elevated.  He had never experienced
pain similar to this in the past. Mr. [**Known lastname 98584**] [**Last Name (Titles) 15797**] nausea,
vomiting and chest pain.  He was admitted to the surgical team
for further care and monitoring.

MEDICAL HISTORY: 1. Coronary artery disease status post CABG in [**2161**].
2. Atrial fibrillation on Coumadin.
3. Vestibular schwannoma treated with chemotherapy at [**Hospital 14852**].
4. History of a hiatal hernia.
5. Total radical resection of the prostate.
6. Bilateral inguinal hernia repairs

MEDICATION ON ADMISSION: plavix, trazadone, protonix, lopressor, ASA, coumadin,
isosorbide, colace, senna

ALLERGIES: Procardia

PHYSICAL EXAM: VIT: Temp 99.6 HR 84 sinus BP 137/62 RR 30 O2 sat 95% on 3L face
mask
EOMI,NC/AT, PERRL, anicteric
CTAB
RRR III/VI systolic murmur
+BS, distended, tympanic, RUQ TTP
no edema, 2+ pedal pulses
foley in place

FAMILY HISTORY: none

SOCIAL HISTORY: The patient denies any tobacco use, but admits to occasional
alcohol use. He lives alone and is retired. 

### Response:
{'Calculus of bile duct with acute cholecystitis, without mention of obstruction,Atrial fibrillation,Cholangitis,Long-term (current) use of anticoagulants,Aortocoronary bypass status'}
