CHIEF COMPLAINT: Abdominal pain, vomiting, abdominal
distention.

PRESENT ILLNESS: The patient is a 74 year-old
female with a history of a radical hysterectomy, omentectomy,
ileocecectomy on [**2131-10-18**] who presented on [**2132-1-19**] with a
four day history of abdominal pain, one day history of
vomiting, and increased abdominal distention.  Chest x-ray
showed free air under the diaphragm.

MEDICAL HISTORY: Ovarian carcinoma status post radical
hysterectomy, omentectomy, ileocecectomy on [**2131-10-18**].  Status
post cholecystectomy, status post dilatation and curettage,
status post C section, depression.

MEDICATION ON ADMISSION: Risperdal, Glyburide 10 mg po q.d.

ALLERGIES: Penicillin.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She lives with her daughter.
Perforation of intestine,Acidosis,Acute kidney failure with lesion of tubular necrosis,Thrombocytopenia, unspecified,Malignant neoplasm of ovary,Peritoneal adhesions (postoperative) (postinfection),Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled
Perforation of intestine,Acidosis,Ac kidny fail, tubr necr,Thrombocytopenia NOS,Malign neopl ovary,Peritoneal adhesions,DMII wo cmp nt st uncntr
Admission Date:  [**2132-1-19**]     Discharge Date:  [**2132-2-4**]

Date of Birth:   [**2057-5-9**]     Sex:  F

Service:  PURPLE TEAM

CHIEF COMPLAINT:  Abdominal pain, vomiting, abdominal
distention.

HISTORY OF PRESENT ILLNESS:  The patient is a 74 year-old
female with a history of a radical hysterectomy, omentectomy,
ileocecectomy on [**2131-10-18**] who presented on [**2132-1-19**] with a
four day history of abdominal pain, one day history of
vomiting, and increased abdominal distention.  Chest x-ray
showed free air under the diaphragm.

PAST MEDICAL HISTORY:  Ovarian carcinoma status post radical
hysterectomy, omentectomy, ileocecectomy on [**2131-10-18**].  Status
post cholecystectomy, status post dilatation and curettage,
status post C section, depression.

MEDICATIONS ON ADMISSION:  Risperdal, Glyburide 10 mg po q.d.

ALLERGIES:  Penicillin.

SOCIAL HISTORY:  She lives with her daughter.

LABORATORIES ON ADMISSION:  Complete blood count, hematocrit
32.3, white cell count 2, platelets 111.  Chem 7 sodium 124,
potassium 2.3, chloride 79, CO2 28, BUN 44, creatinine 2.4,
blood sugar 240.  Arterial blood gases pH 7.46, PCO2 41, PO2
64, white count 30, basophils +4, lactate 2.3.  Chest x-ray
revealed free air under the right diaphragm, superior and
mediastinal mass, bilateral atelectasis.

HOSPITAL COURSE:  Ms. [**Known lastname **] was admitted directly to the
Intensive Care Unit for stabilization following which she was
taken the Operating Room on [**2132-1-19**].  The was operated on by
Dr. [**First Name (STitle) **] [**Name (STitle) **].  She underwent exploratory laporotomy with
lysis of adhesions, resection of leaking anastomosis, distal
ileum and hepatic flexure of colon and ileostomy and
mucofistula of transverse colon.  She was transferred to the
Intensive Care Unit postoperatively.  Her postoperative
course was complicated.  She had a prolonged stay in the
Intensive Care Unit due to persistent acidosis requiring
vasopressors, acute renal failure, prolonged intubation.  She
was extubated on [**2132-1-30**].  She was transferred out of the
Intensive Care Unit on [**2132-2-1**] and is ready for discharge to
rehab currently.

CONDITION ON DISCHARGE:  Stable.

DISCHARGE STATUS:  Awaiting discharge to rehab.

DISCHARGE DIAGNOSIS:
Status post exploratory laporotomy, lysis of adhesions,
resection of leaking anastomosis distal ileum and hepatic
flexure and ileostomy plus mucofistula on [**2132-1-19**].

MEDICATIONS ON DISCHARGE:  1.  Nystatin powder to groin and
axilla b.i.d.  2.  Epogen [**Numeric Identifier **] units subQ twice weekly
Monday and Thursday.  3.  Heparin 5000 units subQ b.i.d.  4.
Lacrilube ointment to each eye q.i.d.  5.  Lopressor 100 mg
per NG tube b.i.d. hold for systolic blood pressure less then
90, heart rate less then 60.  6.  Hydralazine 10 mg per NG
tube q 6 hours hold for a blood pressure less then 100.  7.
Regular insulin sliding scale subQ.  8.  Tylenol 650 mg per
NG tube q 4 to 6 hours prn.  9.  Glyburide 10 mg per NG tube
q.a.m.  10.  Risperdal per NG tube .5 mg q.a.m., 1.5 mg
q.p.m.

TREATMENT:  Stoma therapy.  Finger sticks q 6 hours with
regular insulin sliding scale, venodyne, incentive
spirometer.

DIET:  Impact with fiber at 60 cc per hour via NG tube.  Free
water boluses 250 cc q 4 hours by NG tube.  Swallow study to
be repeated in two weeks.

FOLLOW UP:  Follow up with Dr. [**Last Name (STitle) **], to call for
appointment in one to two weeks.





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

Dictated By:[**Last Name (NamePattern1) 2209**]

MEDQUIST36

D:  [**2132-2-4**]  09:49
T:  [**2132-2-4**]  07:43
JOB#:  [**Job Number 35753**]
{'Perforation of intestine,Acidosis,Acute kidney failure with lesion of tubular necrosis,Thrombocytopenia, unspecified,Malignant neoplasm of ovary,Peritoneal adhesions (postoperative) (postinfection),Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled'}


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, vomiting, abdominal
distention.

PRESENT ILLNESS: The patient is a 74 year-old
female with a history of a radical hysterectomy, omentectomy,
ileocecectomy on [**2131-10-18**] who presented on [**2132-1-19**] with a
four day history of abdominal pain, one day history of
vomiting, and increased abdominal distention.  Chest x-ray
showed free air under the diaphragm.

MEDICAL HISTORY: Ovarian carcinoma status post radical
hysterectomy, omentectomy, ileocecectomy on [**2131-10-18**].  Status
post cholecystectomy, status post dilatation and curettage,
status post C section, depression.

MEDICATION ON ADMISSION: Risperdal, Glyburide 10 mg po q.d.

ALLERGIES: Penicillin.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: She lives with her daughter. 

### Response:
{'Perforation of intestine,Acidosis,Acute kidney failure with lesion of tubular necrosis,Thrombocytopenia, unspecified,Malignant neoplasm of ovary,Peritoneal adhesions (postoperative) (postinfection),Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled'}
