CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 76-year-old female
with CAD, status post CABG, and end-stage renal disease on
peritoneal dialysis who was admitted to an outside hospital
with left lower quadrant abdominal pain. She was found to
have peritonitis probably due to her peritoneal catheter, so
this was removed and she was started on antibiotics. She did
not improve from this and she was taken to the operating room
for an exploratory laparotomy and was found to have a
perforation of her small bowel. A small bowel resection was
performed and the patient was transferred back to the
intensive care unit there. She started to improve and was
transferred to the floor. She then began having increasing
abdominal pain and hypotension. A CT scan was done and she
was found to have extravasation of contrast and concern for
an anastomotic dehiscence. The patient was transferred to
[**Hospital1 **] at this time for further management.

MEDICAL HISTORY: Significant for CAD, hypertension,
AFib, mitral regurgitation, aortic stenosis, COPD, end-stage
renal disease on HD, diabetes mellitus and has a history of
GI bleeds.

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Other suppurative peritonitis,End stage renal disease,Atrial fibrillation,Calculus of gallbladder without mention of cholecystitis, without mention of obstruction,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Chronic airway obstruction, not elsewhere classified,Mitral valve disorders,Encounter for palliative care
Suppurat peritonitis NEC,End stage renal disease,Atrial fibrillation,Cholelithiasis NOS,DMII wo cmp nt st uncntr,Chr airway obstruct NEC,Mitral valve disorder,Encountr palliative care
Unit No:  [**Numeric Identifier 65280**]
Admission Date: [**2196-1-14**]
Discharge Date: [**2196-1-14**]
Date of Birth:  [**2119-12-28**]
Sex:  F
Service:  [**Last Name (un) **]


HISTORY OF PRESENT ILLNESS:  This is a 76-year-old female
with CAD, status post CABG, and end-stage renal disease on
peritoneal dialysis who was admitted to an outside hospital
with left lower quadrant abdominal pain. She was found to
have peritonitis probably due to her peritoneal catheter, so
this was removed and she was started on antibiotics. She did
not improve from this and she was taken to the operating room
for an exploratory laparotomy and was found to have a
perforation of her small bowel. A small bowel resection was
performed and the patient was transferred back to the
intensive care unit there. She started to improve and was
transferred to the floor. She then began having increasing
abdominal pain and hypotension. A CT scan was done and she
was found to have extravasation of contrast and concern for
an anastomotic dehiscence. The patient was transferred to
[**Hospital1 **] at this time for further management.

PAST MEDICAL HISTORY:  Significant for CAD, hypertension,
AFib, mitral regurgitation, aortic stenosis, COPD, end-stage
renal disease on HD, diabetes mellitus and has a history of
GI bleeds.

PAST SURGICAL HISTORY:  Significant for the CABG, the
peritoneal dialysis catheter placement, exploratory
laparotomy and small bowel resection as noted before.

ALLERGIES:  None.

MEDICATIONS:  Her medications on transfer included Tylenol,
regular insulin sliding scale, Protonix, folate, aspirin,
Epogen, oxycodone and Zosyn.

PHYSICAL EXAMINATION:  Temperature 99.6 and heart rate 134.
Her blood pressure was 97/44, respirations 18, and O2
saturation 98%. CVP was 22. She was extremely tender and had
peritoneal signs on her exam.

LABORATORY DATA:  Her white count was 18. Her hematocrit was
39. Her blood gas was 7.41, 36, 101, 24 and zero. Her lactate
was 3.3.

CT scan showed, as noted before, a large amount of ascites
and free air as well as extravasation of contrast.

HOSPITAL COURSE:  The patient was transferred to the
intensive care unit and resuscitation was begun. She was
given broad-spectrum antibiotics, and the patient was taken
to the operating room. She underwent an exploratory
laparotomy and small bowel resection and reanastomosis.
Please see the operative report for further details. However,
intraoperatively, the patient had a bradycardiac arrest
requiring chest compressions and she was started on pressors
for blood pressure control.

She was transferred back to the intensive care unit
postoperatively. She was on high doses of Levophed and on
full vent support. The patient also had an echo immediately
postoperatively which showed significant wall motion
abnormalities with akinesis of the lateral and anterior walls
and hypokinesis of the septum. A family meeting was held at
this time. The family decided that they would not pursue any
other medical treatments. Therefore, the patient was made
comfort measures only.

The pressors were stopped and the patient expired shortly
thereafter. The family refused autopsy at this time. The
patient died on [**2196-1-14**].



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 18475**]

Dictated By:[**Doctor Last Name 11225**]
MEDQUIST36
D:  [**2196-1-14**] 10:27:21
T:  [**2196-1-14**] 11:09:19
Job#:  [**Job Number 65281**]
{'Other suppurative peritonitis,End stage renal disease,Atrial fibrillation,Calculus of gallbladder without mention of cholecystitis, without mention of obstruction,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Chronic airway obstruction, not elsewhere classified,Mitral valve disorders,Encounter for palliative care'}


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: This is a 76-year-old female
with CAD, status post CABG, and end-stage renal disease on
peritoneal dialysis who was admitted to an outside hospital
with left lower quadrant abdominal pain. She was found to
have peritonitis probably due to her peritoneal catheter, so
this was removed and she was started on antibiotics. She did
not improve from this and she was taken to the operating room
for an exploratory laparotomy and was found to have a
perforation of her small bowel. A small bowel resection was
performed and the patient was transferred back to the
intensive care unit there. She started to improve and was
transferred to the floor. She then began having increasing
abdominal pain and hypotension. A CT scan was done and she
was found to have extravasation of contrast and concern for
an anastomotic dehiscence. The patient was transferred to
[**Hospital1 **] at this time for further management.

MEDICAL HISTORY: Significant for CAD, hypertension,
AFib, mitral regurgitation, aortic stenosis, COPD, end-stage
renal disease on HD, diabetes mellitus and has a history of
GI bleeds.

MEDICATION ON ADMISSION: 

ALLERGIES: None.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Other suppurative peritonitis,End stage renal disease,Atrial fibrillation,Calculus of gallbladder without mention of cholecystitis, without mention of obstruction,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Chronic airway obstruction, not elsewhere classified,Mitral valve disorders,Encounter for palliative care'}
