Gastric Outlet Obstruction Caused by a Tapeworm: An Uncommon Presentation of a Common Parasite
Bibliographic record
Abstract
We present a 38-year-old man from Ethiopia with epigastric pain, repeated vomiting, poor appetite over 1 month, with no history of diarrhea, change in stool color, or fever.He showed no response to omeprazole, and examination was unremarkable, and his stools were negative for parasites and Helicobacter pylori antigen.Gastroscopy revealed a bulk of whitish, flat, segmented worm almost completely obstructing the pyloric ring (Figure 1A).There was extensive inflammatory edema involving the antrum and the proximal duodenal mucosa with associated luminal stenosis (B).The worm was gently pushed down into the duodenum using biopsy forceps relieving the obstruction (C).The appearance of the parasite is consistent with a Taenia infection.Because the patient had a history of frequently ingesting raw beef and not pork, it was probably Taenia saginata.To exclude concomitant pathologies, biopsy specimens were taken from the inflamed areas, the result of which showed chronic lymphocytic gastroduodenitis.The patient was treated with single dose of praziquantel 600 mg and pantoprazole 40 mg twice daily and advised not to eat undercooked meat.On re-evaluation 3 days later, he reported passage of dead worms with stool and improvement of his abdominal pain and vomiting.Taenia is a tapeworm acquired by ingesting undercooked beef or pork.Most people with taeniasis are asymptomatic and only become aware of the infection when they pass proglottids in stools.Such gastric obstructive presentations are very uncommon in tapeworm infection, although enteric obstruction with subsequent gastric blockage has been previously reported.1 By contrast, bowel obstruction is a well-recognized complication of ascariasis.2,3
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".