CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 47-year-old
white male with a history of hepatitis B and hepatitis C,
Child C class on the liver transplant list who presented to
the Emergency Room on [**2127-4-10**], with lethargy, weakness,
and a hematocrit of 19, abdominal pain, status post
hemodialysis.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Cirrhosis of liver without mention of alcohol,Other shock without mention of trauma,Acute kidney failure with lesion of tubular necrosis,Other and unspecified coagulation defects,Unspecified protein-calorie malnutrition,Hepatic encephalopathy
Cirrhosis of liver NOS,Shock w/o trauma NEC,Ac kidny fail, tubr necr,Coagulat defect NEC/NOS,Protein-cal malnutr NOS,Hepatic encephalopathy
Admission Date:                   Discharge Date: [**2127-5-6**]

Date of Birth:   [**2080-1-31**]       Sex:  M

Service:  TRANSPLANT SERVICE
HISTORY OF PRESENT ILLNESS:  The patient is a 47-year-old
white male with a history of hepatitis B and hepatitis C,
Child C class on the liver transplant list who presented to
the Emergency Room on [**2127-4-10**], with lethargy, weakness,
and a hematocrit of 19, abdominal pain, status post
hemodialysis.

In the Emergency Room, the patient received 3 U packed red
blood cells and 4 U FFP.  Hematocrit raised from 19 to 22,
and the patient was given approximately 8 L intravenous
fluids, and Dopamine drip for a brief period of hypotension.

hepatitis C, Child C class cirrhosis, and the patient was a
liver transplant candidate.

HOSPITAL COURSE:  The patient was admitted to the Surgical
Intensive Care Unit.  The patient was started on tube feeds
on hospital day #2, and tube feeds were increased to goal
nutritional status.  The patient was initially intubated
because of his worsening respiratory conditions and was
placed on Lasix for diuresis and hemodialysis.  The patient
was hepatitis C cirrhosis and was found to have
intraperitoneal bleeding and positive paracentesis sample for
coagulase negative Staphylococcus aureus. Infectious Disease
was consulted on [**4-16**], and with their recommendation,
resampling of the ascitic fluids were carried out, and the
patient was started on Vancomycin; however, the patient's
condition still remained critical.

In the Intensive Care Unit, he was still intubated with
multiple blood transfusions for platelet coagulation factors.
FFP and packed red blood cells were given in order to stop
the hemorrhage and correct his coagulopathy.  The patient
developed ARDS on hospital day #3.  Several attempts to tap
the ascites were carried out, and each time several liters of
fluid was removed.  Per Nephrology recommendation, the
patient was started on CVVH on [**2127-4-22**], for rising BUN
and creatinine because the patient was not able to tolerate
the hemodialysis due to hypotension.

On [**4-24**], the patient was started on TPN due to his
worsening nutritional status.  On [**4-27**], a large volume
paracentesis was again carried out.  Approximately 6.5 L of
fluid was drained from his ascites.  The patient's condition
continued to deteriorate in the Intensive Care Unit.  On
hospital day #22, it was decided that the patient was no
longer eligible for liver transplant due to his worsening
medical condition, and the patient was taken off the
transplant list, and the options were discussed with the
family members.

With the patient requiring blood products almost daily due to
his coagulopathy and liver failure, on [**2127-5-6**], it was
discussed with the patient's family, and the patient was made
DNR and CMO.  After withdraw of the care per family, the
patient expired at 1852 on [**2127-5-6**].  Dr. [**Last Name (STitle) **] and Dr.
[**Last Name (STitle) 13853**] was notified, and the options were discussed with the
patient's family regarding postmortem examination.  The
patient's sister refused.

The patient expired due to end-stage liver disease,
cirrhosis, and cardiopulmonary arrest, and multiple organ
failures.







                            [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 707**], M.D.,Ph.D.  02-366

Dictated By:[**First Name3 (LF) 13854**]
MEDQUIST36

D:  [**2127-5-6**]  19:45
T:  [**2127-5-6**]  19:51
JOB#:  [**Job Number 13855**]
{'Cirrhosis of liver without mention of alcohol,Other shock without mention of trauma,Acute kidney failure with lesion of tubular necrosis,Other and unspecified coagulation defects,Unspecified protein-calorie malnutrition,Hepatic encephalopathy'}


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 47-year-old
white male with a history of hepatitis B and hepatitis C,
Child C class on the liver transplant list who presented to
the Emergency Room on [**2127-4-10**], with lethargy, weakness,
and a hematocrit of 19, abdominal pain, status post
hemodialysis.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Cirrhosis of liver without mention of alcohol,Other shock without mention of trauma,Acute kidney failure with lesion of tubular necrosis,Other and unspecified coagulation defects,Unspecified protein-calorie malnutrition,Hepatic encephalopathy'}
