A Rare Cause of Abdominal Pain and Hematochezia
Bibliographic record
Abstract
A 72-year-old female with metastatic stage 1B leiomyosarcoma was admitted to hospital due to increasing hip pain secondary to a pathological left acetabular fracture caused by a metastatic lytic lesion. The patient underwent a left cemented total hip arthroplasty and was undergoing rehabilitation postoperatively. Approximately 10 days after admission, she developed abdominal pain and hematochezia. Her hemoglobin dropped 16 points, from a baseline of 80 to 64. A colonoscopy was then performed, which revealed a tubular mass extending distally from the cecum (Figure A) to the transverse colon (Figures B and C). The mass originated from the ileocecal valve, and the terminal ileum could not be intubated. An urgent CT scan of the abdomen/pelvis was then performed, revealing an ileocolonic intussusception within the right abdomen, extending over at least 12 cm (Figure D). The patient underwent a right hemicolectomy the following day. Pathology of the surgically resected bowel revealed a 4.2-cm metastatic tumor deposit from her known leiomyosarcoma cancer at the tip of the intussuscepted bowel in the ileum. Focal acute ischemic changes were also seen. Postoperatively the patient was doing very well, with resolution of her abdominal pain and hematochezia.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)
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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 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
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".