Hybrid interventional radiological and surgical approach to treat biliary obstruction post Kasai portoenterostomy: A case report
Bibliographic record
Abstract
Kasai procedure is used in the management of biliary atresia. Complications can include structuring at anastomoses which can result in impeded bile flow and subsequently ascending cholangitis that requires management. We present a case of a 4-years old with multiple episodes of ascending cholangitis in the context of prior Kasai portoenterostomy at day 56 of life for non-syndromic biliary atresia. After prolonged hospital admission, imaging in the form of US and MR-cholangiopancreatography showed an obliterated portoenterostomy. A combined surgical and Interventional Radiology approach was utilized in the form of the surgical creation loop jejunostomy within the Roux limb and then traversing of the portoenterostomy under fluoroscopically to dilate the stricture and place an internal-external biliary drain. Subsequently, the patient’s hyperbilirubinemia resolved with no further episodes of ascending cholangitis in 3 years of follow-up. A hybrid, percutaneous and surgical approach is a feasible option to restore bile flow in patients post-Kasai who develop delayed cholestasis due to obliteration of the portoenterostomy
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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".