A Systematic Review of Prenatally Diagnosed Intra-abdominal Enteric Duplication Cysts
Bibliographic record
Abstract
INTRODUCTION: With improvements in prenatal ultrasound, more abdominal enteric duplication cysts (EDCs) are diagnosed prenatally. The optimal time for operative intervention is unclear. We aimed to review the evidence supporting the indication and timing of surgery for prenatally diagnosed EDCs. MATERIALS AND METHODS: A systematic review was performed using a defined search strategy identifying articles with inclusion criteria of prenatal diagnosis of histologically confirmed EDCs. Outcomes included (1) indications for resection (symptoms vs. prophylactic) and (2) time from birth to operative intervention. RESULTS: Of 1,590 articles screened, prenatal diagnosis of histologically confirmed EDCs was made in 68 articles, detailing indications and timing for resection for 86 patients. Thirty-five patients (41%) became symptomatic early and were resected promptly at a median of 2 days of age. Indications for intervention included bowel obstruction, volvulus, bleeding, recurrent pain and diagnostic dilemma (concern for cystic neuroblastoma). There were 51 patients (59%) who were resected prophylactically at a median of 90 days of age without interval symptoms. Symptomatic cysts had a larger mean cyst diameter. There was a difference in the anatomic distribution of asymptomatic or symptomatic EDCs-gastric duplications were more frequently asymptomatic while jejunal, proximal ileal and colonic duplications were more frequently symptomatic. CONCLUSION: The optimal approach to EDCs diagnosed prenatally is not supported by strong evidence in the literature. Our systematic review indicates that almost half of the infants diagnosed prenatally become symptomatic early and are resected. In asymptomatic patients, close observation and delayed prophylactic resection in infancy can be considered.
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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 | 0.006 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.005 |
| Bibliometrics | 0.017 | 0.018 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".