Tubular colonic duplication and intestinal malrotation in a child: A case report
Bibliographic record
Abstract
Introduction Pediatric colonic duplication is a rare entity that has a wide range of clinical presentations. It is rarely associated with other congenital malformations. Case Presentation A 2-year-old girl presented to the emergency department with a five-day history of obstipation, vomiting, and worsening abdominal distension. She had a history of chronic constipation. She was found to have an elevated white blood cell count and C-reactive protein. Abdominal plain films and computed tomography findings were suggestive of a large bowel obstruction and included a mesenteric swirl sign concerning for an intestinal volvulus. The patient was taken to the operating room for an emergent exploratory laparotomy. The colon was noted to be significantly dilated. We found an additional loop of bowel coming off from the cecum. This was a tubular duplication, two feet in length, that was also dilated. The duplication had its own mesentery and blood supply coming off the ileocolic pedicle. The site of the colonic obstruction was in the transverse colon, caused by an adhesive band. We performed an extended right hemicolectomy as the colon appeared unhealthy and we suspected that the duplicated colonic segment could have contributed to the patient’s symptoms and could be at risk of volvulus in the future. The duplicated colonic segment was resected with the normal colon. We then examined the small bowel and found that it was malrotated, so we did a Ladd procedure. The patient recovered uneventfully and was discharged six days later. She continues to do well, and her chronic constipation has resolved. Conclusion Colonic duplications must be included in the differential diagnosis of children who develop chronic constipation and/or acute intestinal obstruction. Patients who have colonic duplications should be studied to rule out other intestinal anomalies such as intestinal malrotation.
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How this classification was reachedexpand
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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".