Chronic Gastric Volvulus in Traumatic Hiatus Hernia Managed by Gastrostomy
Bibliographic record
Abstract
Gastric volvulus is a rare entity. It occurs more frequently in the elderly with a hiatus hernia and only in 10-20% in infants and children. We report a rare case of an elderly patient with chronic gastric volvulus in traumatic hiatus hernia after a severe injury of the chest. He had a medical history of diabetes mellitus, severe cardiopathy with pacemaker, chronic respiratory disease and six months ago a road accident with a severe injury of the chest. Gastric volvulus was diagnosed endoscopically, confirmed radiologically and managed operatively with fixation of the stomach by gastrostomy. The patient during the diagnostic approach and until the surgical procedure was managed by nasogastric tube without bilious backflow, intravenous fluid administration, balance of electrolyte and parenteral nutrition. The successful treatment of the gastric volvulus with a simple fixation of the stomach on the anterior abdominal wall justifies the decision to avoid an attempt of hiatus hernia repair particularly in an elderly patient with a high operative risk. However, a delayed diagnosis may be threatening to the patient ’ s life and what should be highlighted is the difficulty of the diagnosis and the management in rare cases, such as chronic volvulus of the stomach. doi: http://dx.doi.org/10.4021/jmc1041w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".