Resection of Fibrous Pseudocapsule in a Patient with Secondary Achalasia and Persistent Symptoms After Removal of Adjustable Gastric Band: Case Report and Review of the Literature
Bibliographic record
Abstract
Background: Secondary achalasia in the setting of an adjustable gastric band is a known, but rare complication. Most of the symptoms usually resolve after deflating or removing the gastric band, but dysphagia symptoms may persist. We present a case report of a patient with secondary achalasia in the setting of an adjustable gastric band, who required delayed resection of fibrous pseudocapsule to treat persistent dysphagia symptoms after removal of the gastric band. Methods: We performed a literature search using EMBASE and MEDLINE databases to review literature on persistent dysphagia symptoms after removal of adjustable gastric band in the setting of secondary achalasia. Results: We present the case of a patient who had secondary achalasia in the setting of an adjustable gastric band. Despite removal of the gastric band, dysphagia symptoms persisted, requiring delayed resection of fibrous pseudocapsule to relieve the obstructive symptoms. We review the literature from three case reports and two conference abstracts discussing persistent dysphagia symptoms after removal of adjustable gastric band in the setting of secondary achalasia. Conclusion: Our recommendation is to resect anterior portion of the fibrous pseudocapsule at the time of removal of an adjustable gastric band in patients with suspected secondary achalasia.
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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 | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".