Bilioptysis due to a single transcavitary thoracoabdominal gunshot wound
Bibliographic record
Abstract
A 27-year-old man was transported to our trauma center after sustaining a single gunshot wound. On arrival, he was hemodynamically stable and neurologically intact, with a non-tender abdomen and negative FAST (focused assesment with sonography in trauma). Complete skin examination revealed a wound on his left hip and no additional injuries. CT demonstrated a trans-thoracoabdominal trajectory with a single projectile embedded in the right chest wall and suspected injuries to the duodenum, descending colon, pancreatic head, gall bladder, liver, and diaphragm (figure 1). Figure 1 CT of chest and abdomen showing tract of the projectile. A trauma laparotomy was performed, and the patient was found to have gross disruption of the anterior first and second parts of the duodenum, distal common bile duct injury, perforation of the gall bladder, liver injury traversing segments 4b and 8, sigmoid mesocolon injury, right diaphragm perforation, and right hemopneumothorax. No definitive pancreatic duct injury was identified. Given ongoing hemodynamic and metabolic stability, definitive repair was completed, including right chest tube insertion, primary repair of the right diaphragm, cholecystectomy, primary duodenal repair, pyloric exclusion with Roux-en-Y gastrojejunostomy, hepaticojejunostomy, sigmoid mesocolon repair, and wide drainage for possible pancreatic injury. Postoperatively, a pancreatic leak was noted, which resolved with medical treatment including total parenteral nutrition and a somatostatin analogue. Three weeks after …
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 teacher head, 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".