Gastric Volvulus Secondary to Paraesophageal Hernia Causing Gastric Necrosis and Perforation of the Gastroesophageal Junction
Bibliographic record
Abstract
Gastric volvulus is a potentially lethal condition with significant morbidity and mortality if not recognized and managed promptly and appropriately. We report a case of gastric volvulus secondary to paraesophageal hernia causing gastric necrosis and perforation of the gastroesophageal junction. An 82-year-old woman with a large paraesophageal hernia was admitted to our hospital with vague epigastric and right-sided chest pain. She was taken to surgery and laparotomy findings included a large paraesophageal hernia, gastric volvulus with ischemia, frank gangrene and perforation at the gastroesophageal junction. She underwent reduction of the hernia and gastric volvulus with partial gastroesophagectomy and formation of an esophagogastrostomy anastomosis. Due to the patient’s old age and associated co-morbidities, her prognosis remained poor post-operatively and she was transferred to hospice care as per family wishes. This case report is intended to educate clinicians to maintain a high index of suspicion for acute gastric volvulus and its potential complications in the appropriate clinical setting to allow for early surgical intervention and appropriate management. J Med Cases. 2015;6(7):309-312 doi: https://doi.org/10.14740/jmc2191w
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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 | 0.004 |
| 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 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".