Gallstone ileus with sigmoid impaction through a cholecystocolic fistula: a case report
Bibliographic record
Abstract
Gallstone ileus is a rare cause of bowel obstruction. Colonic impaction, especially in the sigmoid colon, is extremely uncommon and often associated with diverticulosis or structural abnormalities. An 81-year-old woman presented with 2 weeks of abdominal pain, bloating, nausea, and vomiting. A computed tomography (CT) scan revealed a 6.2 cm gallstone in the sigmoid colon with pneumobilia and a cholecystocolonic fistula. After unsuccessful colonoscopic extraction, she underwent laparoscopic enterolithotomy with segmental sigmoid resection. She recovered without complications and remained symptom-free at her 6-week follow-up. Colonic gallstone ileus is rare and should be suspected in elderly women with obstruction and pneumobilia. A CT scan is the diagnostic gold standard. While endoscopy may work for small stones, surgery is usually required. Enterolithotomy with or without resection remains the safest approach in frail patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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 | 0.001 |
| 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".