Identifying the impossible: piecemeal cold snare resection perforation
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background and Aim: Piecemeal cold snare resection (CSR) is an increasingly adopted technique for large nonpedunculated colorectal polyps because of its favorable safety profile. Although adverse events are rare, perforation after CSR has been reported infrequently. We present a video case of intraprocedural perforation during piecemeal CSR. Methods: A 63-year-old woman with quiescent colonic Crohn disease underwent dysplasia surveillance, revealing multiple flat polyps, including 2 adjacent large 0-IIA transverse colon polyps. Piecemeal CSR was performed using chromoinjectate and a 10-mm cold snare. Careful inspection of the resection base with submucosal chromoendoscopy revealed a type IV deep mural injury, despite the absence of electrocautery. The defect was closed using through-the-scope clips. The patient was observed and discharged with antibiotics, with no delayed adverse events at follow-up. Histopathology confirmed sessile serrated lesions without dysplasia. Conclusion: This case demonstrates that perforation, although rare, can occur during CSR. Endoscopists should perform meticulous resection base assessments, as the absence of cautery may obscure signs of deep mural injury.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it