Surgical management of incarcerated cecostomy intussusception following refractory acute colonic pseudo-obstruction
Bibliographic record
Abstract
Acute colonic pseudo-obstruction (ACPO), or Ogilvie's syndrome, is a rare but serious condition of colonic dilation without mechanical obstruction. Management becomes increasingly complex in patients with significant baseline comorbidities. We describe a 69-year-old female with extensive comorbidities who presented with acute on chronic hypoxic respiratory failure due to influenza pneumonia. During a prolonged ICU course, she developed progressive abdominal distension and was diagnosed with ACPO refractory to conservative and pharmacologic management. The patient was taken to surgery where a cecostomy was matured. Subsequently, she developed an incarcerated cecostomy intussusception. Surgical exploration revealed chronic right colon dilation and cecal prolapse, prompting a right hemicolectomy with end-ileostomy. This case highlights the role of stepwise surgical intervention in refractory ACPO, particularly in medically complex patients. While cecostomy may serve as a temporizing measure, complications such as intussusception may necessitate definitive resection. A tailored surgical approach is essential for optimizing outcomes.
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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 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 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".