Iatrogenically Displaced Renal Calculus During Percutaneous Lithotripsy That Mimicked Duodenal Perforation by Resembling Leaked Oral Contrast
Bibliographic record
Abstract
Percutaneous lithotripsy (nephrolithotripsy) is an interventional procedure in which renal calculi are removed from the kidney through a tube which is inserted percutaneously. The procedure removes the necessity of surgery, but still bears the risk of certain complications, including displacement of calculi or their fragments. We present a 56-year-old female patient who was brought to the radiology department with the suspicion of duodenal perforation. The patient had undergone a percutaneous intervention for lithotripsy, but things had gone rather unlucky and the stone had been mobilized out from its original location at the lower pole of the right kidney, by the impact of a stiff nelaton catheter tip used during the intervention. Following the intervention, she had developed an upper abdominal pain. At computed tomography (CT) obtained with oral contrast with the suspicion of a duodenal perforation, a fluid collection and a hyper-dense focus were noted at the near vicinity of the duodenum. The density was originally thought to represent extravasated oral contrast from the duodenum, but later it was found to be due to the calculus that was driven out from the right kidney during the interventional attempt to perform a percutaneous lithotripsy. Renal calculus displacement may be a serious complication of lithotripsy, leading to certain misdiagnoses including hollow-organ penetration. Care and commanding know-how of the procedure are of utmost importance in dealing with such situations. J Med Cases. 2014;5(7):408-410 doi: http://dx.doi.org/10.14740/jmc1811e
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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 | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.005 | 0.004 |
| 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".