Laparoscopic Hemihysterectomy for Uterus Didelphys Following Laparotomy
Bibliographic record
Abstract
Introduction: Mu ¨llerian anomalies can be challenging to diagnose.We describe a patient with uterus didelphys and cervical atresia who presented with a symptomatic pelvic mass that was incompletely diagnosed as an endometrioma.Consequently, it was inadequately treated at the time of laparotomy, necessitating a laparoscopic hemihysterectomy for definitive management.Case Description: A 17-year-old nulligravida presented with abdominal pain and pelvic pressure.Computed tomographic imaging showed an 18-cm pelvic mass and left renal agenesis.The patient underwent an exploratory laparotomy with resection of a large endometrioma and left salpingo-oophorectomy.During the operation, an enlarged left uterine horn was observed and was kept intact.She made an uneventful recovery, but returned 6 months later with pelvic pain and pressure.Ultrasonography and hysterosalpingogram diagnosed uterus didelphys with left cervical atresia causing an obstructed hemiuterus.Laparoscopic hemihysterectomy with extensive adhesiolysis was performed, and the patient's symptoms resolved.Discussion: Endometrioma is rare in adolescents, and its presence should raise suspicion of a mu ¨llerian anomaly.Laparoscopic management, while safe and feasible, is more challenging in the setting of dense adhesions from a prior laparotomy.Preoperative magnetic resonance imaging is recommended in adolescents who present with chronic pelvic pain and a symptomatic pelvic mass, to rule out a congenital anomaly and avoid a needless second surgery.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| 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".