Nonneoplastic Intraluminal Causes of Inflammatory Strictures of Small Bowel: A Case Series
Bibliographic record
Abstract
Small bowel obstructions are primarily caused by adhesions, hernias, neoplasms, or inflammatory strictures. Most cases of inflammatory strictures are caused by extraluminal adhesions due to postoperative inflammatory changes. Nonneoplastic intraluminal inflammatory strictures of small bowel are rare but pose a complex clinical problem, with the successful management depending on comprehensive knowledge of the etiology and pathophysiology. Detailed retrospective multidisciplinary review of selected cases of nonneoplastic inflammatory small bowel strictures was performed to correlate etiology with the clinical presentation, imaging, pathologic findings, and management outcome. Various parameters, including clinical presentation, imaging findings, and gross and microscopic patterns of injury, were taken into consideration to define differences between Crohn-related and non–Crohn-related causes of small bowel strictures. The study included 11 cases (men, 6; women, 4; age range, 24-83 years) with different etiologies (Crohn disease, 4 cases; NSAID enteropathy, 2 cases; ischemia, 1 case; visceral myopathy, 1 case; congenital bowel adhesions, 1 case; vasculitis, 1 case; and cryptogenic multifocal ulcerous stenosing enteritis, 1 case). Crohn-related strictures present predominantly in a chronic or subacute manner with transmural involvement, collagen deposition, and an inflammatory infiltrate composed of a predominance of plasma cells and eosinophils with scattering of mast cells. Non–Crohn-related strictures differ in gross and microscopic appearances, depending on the etiology, generally exhibiting partial wall involvement with fibrosis and a chronic inflammatory infiltrate with a predominance of lymphocytes. Small bowel obstruction remains a serious clinical problem with significant morbidity. Despite overlapping features, there are some distinguishing histomorphologic and clinical criteria that are specific to different etiologies, indicating diverse mechanisms of stricture formation. More detailed study into these mechanisms may help predict recurrence and clinical outcome and define management protocols for these cases to reduce morbidity and mortality.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".