CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is an 88 year old
female with past medical history of coronary artery disease,
hypertension, congestive heart failure and atrial
fibrillation, sigmoid volvulus history about one year ago
reduced with colonoscopy.  The patient did well until one day
prior to admission when she developed increased abdominal
girth with nausea, vomiting and no bowel movements for the
past day.  The patient had a KUB that showed sigmoid
volvulus.

MEDICAL HISTORY: 1.  Hypertension.
2.  Congestive heart failure.
3.  Atrial fibrillation.
4.  History of deep vein thrombosis.
5.  Hypothyroidism.

MEDICATION ON ADMISSION: 1.  Zantac 150 mg.
2.  Lasix 60 mg.
3.  Levoxyl 125.
4.  Prozac 10 mg.
5.  Aspirin 81 mg once daily.

ALLERGIES: Penicillin and Valium.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Volvulus,Urinary tract infection, site not specified,Congestive heart failure, unspecified,Atrial fibrillation,Unspecified acquired hypothyroidism,Unspecified essential hypertension
Volvulus of intestine,Urin tract infection NOS,CHF NOS,Atrial fibrillation,Hypothyroidism NOS,Hypertension NOS
Admission Date:  [**2152-11-17**]       Discharge Date:  [**2152-11-29**]


Service:  GENERAL SURGERY

HISTORY OF PRESENT ILLNESS:  The patient is an 88 year old
female with past medical history of coronary artery disease,
hypertension, congestive heart failure and atrial
fibrillation, sigmoid volvulus history about one year ago
reduced with colonoscopy.  The patient did well until one day
prior to admission when she developed increased abdominal
girth with nausea, vomiting and no bowel movements for the
past day.  The patient had a KUB that showed sigmoid
volvulus.

PAST MEDICAL HISTORY:
1.  Hypertension.
2.  Congestive heart failure.
3.  Atrial fibrillation.
4.  History of deep vein thrombosis.
5.  Hypothyroidism.

PAST SURGICAL HISTORY:  Right tibial fracture repair.

ALLERGIES:  Penicillin and Valium.

MEDICATIONS ON ADMISSION:
1.  Zantac 150 mg.
2.  Lasix 60 mg.
3.  Levoxyl 125.
4.  Prozac 10 mg.
5.  Aspirin 81 mg once daily.

PHYSICAL EXAMINATION:  On examination, the patient was
afebrile, vital signs were stable.  The patient had
normoactive bowel sounds, distended, tympanitic, minimally
tender.

LABORATORY DATA:  White count 19.0 with 90 neutrophils, 3
bands, hematocrit 48.5, platelet count 232,000.  Potassium
3.7.

HOSPITAL COURSE:  The patient underwent sigmoidoscopy which
accomplished decompression and resolution of volvulus.  A #28
French chest tube was placed across the area of the volvulus.
Tube was draining well fecal material.  Abdominal distention
was decreased.  On hospital day three, it was noted that the
rectal tube had become obstructed with fecal drainage coming
around the tube.  Temperature had risen to 102.6 overnight.
On examination, the abdomen had become distended again.
Decision was made to undergo sigmoid colectomy with end
colostomy and [**Doctor Last Name **] procedure.  The patient was admitted to
the Surgical Intensive Care Unit postoperatively intubated
for blood pressure control.  The patient was extubated
postoperative day one.  The patient was felt to be ready for
transfer to the floor after some blood pressure issues that
were resolved in the Intensive Care Unit.  The patient
finally was transferred to the floor on postoperative day six
after some delay due to placement.  Postoperative day seven
the patient was with no complaints, tolerating soft solids,
on tube feeds, vital signs stable, abdomen soft, nontender,
nondistended with positive bowel sounds, incision clean, dry
and intact.  Postoperative day eight the patient continued to
be afebrile with vital signs stable.  The patient is now
tolerating thick liquids.  The patient was advanced to pureed
foods, and Foley was discontinued.  Postoperative day nine,
the patient continued to do well with no complaints,
tolerating pureed solids well.  The patient had inadvertently
pulled out feeding tube shortly before the morning rounds.
As the patient was taking good p.o. intake, it was felt that
the feeding tube was no longer necessary.  The patient
continued to be afebrile and vital signs were stable.  The
abdomen was soft, nontender, nondistended with normoactive
bowel sounds.  The incision was clean, dry and intact.  The
patient was awaiting rehabilitation placement.  The patient
will be going to a rehabilitation facility and will follow-up
with Dr. [**Last Name (STitle) 519**] the following week.

CONDITION ON DISCHARGE:  Good.

DISCHARGE STATUS:  To rehabilitation facility to be named at
a later date.

DISCHARGE DIAGNOSIS:
1.  Status post sigmoid colectomy with end colostomy,
[**Doctor Last Name 3379**] procedure.
2.  Congestive heart failure.
3.  Atrial fibrillation.
4.  Hypothyroidism.

FOLLOW-UP: The patient will be following up with Dr. [**Last Name (STitle) 519**].




                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**], M.D.  [**MD Number(1) 521**]

Dictated By:[**Name8 (MD) 5915**]
MEDQUIST36

D:  [**2152-11-28**]  20:15
T:  [**2152-11-28**]  20:51
JOB#:  [**Job Number 102857**]

cc:[**Last Name (NamePattern1) 102858**]
{'Volvulus,Urinary tract infection, site not specified,Congestive heart failure, unspecified,Atrial fibrillation,Unspecified acquired hypothyroidism,Unspecified essential hypertension'}


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 an 88 year old
female with past medical history of coronary artery disease,
hypertension, congestive heart failure and atrial
fibrillation, sigmoid volvulus history about one year ago
reduced with colonoscopy.  The patient did well until one day
prior to admission when she developed increased abdominal
girth with nausea, vomiting and no bowel movements for the
past day.  The patient had a KUB that showed sigmoid
volvulus.

MEDICAL HISTORY: 1.  Hypertension.
2.  Congestive heart failure.
3.  Atrial fibrillation.
4.  History of deep vein thrombosis.
5.  Hypothyroidism.

MEDICATION ON ADMISSION: 1.  Zantac 150 mg.
2.  Lasix 60 mg.
3.  Levoxyl 125.
4.  Prozac 10 mg.
5.  Aspirin 81 mg once daily.

ALLERGIES: Penicillin and Valium.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Volvulus,Urinary tract infection, site not specified,Congestive heart failure, unspecified,Atrial fibrillation,Unspecified acquired hypothyroidism,Unspecified essential hypertension'}
