Surgical Management of Duodenal Perforation in a Patient With Gardner Syndrome and Abdominal Wall Reconstruction
Bibliographic record
Abstract
Duodenal perforation is a rare complication of esophagogastroduodenoscopy (EGD) and may be caused by direct injury from the endoscope during the procedure. This complication has a relatively high mortality rate but can be reliably managed with surgical repair. We present the case of a young man with Gardner syndrome who obtained a duodenal perforation during a surveillance EGD with endoscopic mucosal resection (EMR). Our patient was deemed a poor surgical candidate due to previous excision of a large abdominal wall desmoid tumor with cadaveric graft reconstruction that in turn created limited access for any subsequent abdominal surgeries. As such, he underwent multiple failed endoscopic repairs before definitive surgical management with a Graham patch repair using a unique entry approach. This case highlights the treatment course of this rare patient. J Curr Surg. 2021;11(3):61-64 doi: https://doi.org/10.14740/jcs443
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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 | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| 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 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".