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 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) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| 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".