Fístula pieloduodenal com evolução para obstrução duodenal por pielonefrite crônica - relato de caso e revisão da literatura
Bibliographic record
Abstract
A fístula pieloduodenal está associada a complicações de doenças do trato urológico, sendo a pielonefrite crônica por nefrolitíase a causa mais comum desta rara patologia. Será reportado a história clínica com exames diagnósticos, intervenção cirúrgica e manejo pós-operatório de uma paciente do sexo feminino, 55 anos, com quadro de obstrução duodenal por pielonefrite crônica em rim direito associado a fístula pieloduodenal de longa data, diagnosticado por tomografia computadorizada e endoscopia digestiva alta. Foi submetida a nefrectomia direita total e duodenorrafia no mesmo tempo cirúrgico, evoluiu com fístula e subestenose duodenal sendo indicado tratamento endoscópico à vácuo e dilatação endoscópica com balão, com resolução de ambas as complicações. Realizada revisão da literatura para discutir etiologias, apresentações, diferenças e semelhanças com casos relacionados ao manejo das fístulas pieloduodenais. Este relato ressalta a importância da multidisciplinaridade na abordagem diagnóstica e terapêutica de uma patologia grave e rara.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| 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".