{
  "vercy": "1.0-draft",
  "publication": {
    "status": "research-draft",
    "adjudicationStatus": "unreviewed",
    "publishableCanonical": false,
    "generatedAt": "2026-09-13T04:55:41Z",
    "providers": [
      "Claude"
    ],
    "breadth": "written by Claude from model knowledge without web access - no source was read, every claim is a lead to verify",
    "pass": 2,
    "wave": 3,
    "engine": "claude",
    "enrichment": {
      "pass": 3,
      "engine": "claude",
      "producedAt": "2026-10-06T10:00:00Z",
      "ingestedAt": "2026-10-06T07:07:39+00:00",
      "fields": [
        "agent_conduct",
        "ethics",
        "owners"
      ]
    }
  },
  "metaModel": {
    "id": "THING-Q16244733",
    "registryId": "vr.tr.bowel-obstruction",
    "name": "bowel obstruction",
    "version": "0.2.0-wave.3",
    "entryKind": "thing",
    "family": "Thing Registry",
    "domain": [
      "XCT.STA"
    ],
    "status": "research-draft"
  },
  "canonicalUrl": "https://ver.cy/models/thing/q16244733/",
  "model": {
    "registry_id": "vr.tr.bowel-obstruction",
    "name": "bowel obstruction",
    "purpose": "Let an agent explain bowel obstruction and its causes in neutral terms, relay symptoms, diagnosis and management in general from surgical sources, describe neonatal and special forms, and route anyone with symptoms to emergency care.",
    "definition": "A mechanical or functional blockage of the small or large intestine that prevents the normal passage of contents, caused by adhesions, hernias, tumours, volvulus, intussusception, impaction or, in newborns, congenital atresia and conditions such as distal intestinal obstruction syndrome in cystic fibrosis, presenting with abdominal pain, distension, vomiting and constipation; bowel obstruction is a medical emergency that can lead to ischaemia and perforation and is managed with decompression, fluids and often surgery.",
    "what_it_is_for": "Not applicable; a condition.",
    "affordances": [
      "explain causes",
      "relay diagnosis and management in general",
      "describe special forms",
      "route to emergency care"
    ],
    "distinguishing_features": [
      "Mechanical or functional block",
      "Pain, distension, vomiting",
      "Emergency",
      "Surgical management"
    ],
    "appearance": "Not a visible object; abdominal distension and vomiting.",
    "visual_identification": [
      "Blockage of the intestine",
      "Small bowel obstruction, duodenal obstruction, volvulus, impaction, neonatal obstruction, distal intestinal obstruction syndrome",
      "Ileus is functional without mechanical block; constipation alone is not obstruction"
    ],
    "physical_properties": [
      {
        "quantity": "most common small bowel cause",
        "typical_range": "adhesions",
        "unit": "cause",
        "note": "about 60 percent in adults"
      },
      {
        "quantity": "most common large bowel cause",
        "typical_range": "colorectal cancer",
        "unit": "cause",
        "note": "in adults"
      }
    ],
    "families_and_kinds": [
      "small bowel obstruction from adhesions and hernias",
      "large bowel obstruction from tumours and volvulus",
      "duodenal obstruction",
      "intestinal volvulus and intussusception",
      "impaction including faecal impaction and distal intestinal obstruction syndrome",
      "neonatal bowel obstruction from atresia and other congenital causes"
    ],
    "related_models": [
      {
        "relation": "is a kind of",
        "target": "intestinal disease",
        "why": "in registry terms"
      },
      {
        "relation": "is caused by",
        "target": "adhesion",
        "why": "after abdominal surgery"
      },
      {
        "relation": "is contrasted with",
        "target": "ileus",
        "why": "a functional obstruction"
      },
      {
        "relation": "is treated by",
        "target": "emergency surgery",
        "why": "when needed"
      }
    ],
    "identifiers": [
      {
        "scheme": "ICD-11",
        "value_or_pattern": "DA91",
        "note": "intestinal obstruction"
      },
      {
        "scheme": "MeSH",
        "value_or_pattern": "D007415",
        "note": "intestinal obstruction"
      }
    ],
    "standards_and_regulation": [
      "Surgical society guidelines such as the Bologna guidelines for adhesive small bowel obstruction",
      "Emergency care protocols"
    ],
    "failure_modes_and_hazards": [
      "Delay leading to ischaemia and perforation",
      "Agents giving personal medical advice",
      "Confusing obstruction with ileus or constipation"
    ],
    "in_scope": [],
    "out_of_scope": [],
    "characteristics": [],
    "agent_conduct": {
      "may": [
        "Explain causes and warning signs of bowel obstruction from medical sources.",
        "Urge a person with signs such as vomiting, distension and inability to pass stool or gas to seek urgent care."
      ],
      "must_not": [
        "Advise a person to treat a suspected obstruction at home with laxatives or enemas.",
        "Diagnose or rule out bowel obstruction from a description of symptoms.",
        "Delay a person's access to emergency care."
      ],
      "requires_human": [
        "Any decision about surgery or treatment."
      ]
    },
    "ethics": {
      "considerations": [
        "Bowel obstruction can become fatal within hours if left untreated.",
        "Infants and frail older people may not report symptoms clearly."
      ],
      "affected_parties": [
        "Patients",
        "Newborns and their parents",
        "Carers of older people"
      ]
    },
    "owners": {
      "steward": "Nobody owns the condition; treating clinicians answer for care.",
      "master_systems": []
    }
  },
  "sources": [
    {
      "id": "wikidata",
      "title": "Wikidata item Q16244733: bowel obstruction",
      "url": "https://www.wikidata.org/wiki/Q16244733",
      "url_status": "live",
      "what_it_supports": "identity and sense of the item",
      "checked_by": "wikidata-api"
    },
    {
      "id": "wikipedia-en",
      "title": "Wikipedia: Bowel obstruction",
      "url": "https://en.wikipedia.org/wiki/Bowel_obstruction",
      "url_status": "live",
      "what_it_supports": "general description of the item",
      "checked_by": "wikidata-api sitelink"
    }
  ],
  "structure": {
    "bundles": [
      {
        "id": "help",
        "name": "Help",
        "description": "Emergency first.",
        "rationale": "Safety.",
        "layers": [
          {
            "id": "emergency",
            "name": "Emergency",
            "description": "Emergency.",
            "findings": [
              {
                "id": "emergency-finding",
                "name": "Emergency",
                "description": "Emergency.",
                "questions": [
                  {
                    "text": "Why do severe abdominal pain with vomiting, distension and no passage of stool or gas need emergency care immediately?",
                    "kind": "action"
                  },
                  {
                    "text": "Is the user describing these symptoms now, which means calling emergency services?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          },
          {
            "id": "newborns",
            "name": "Newborns",
            "description": "Newborns.",
            "findings": [
              {
                "id": "newborns-finding",
                "name": "Newborns",
                "description": "Newborns.",
                "questions": [
                  {
                    "text": "What signs of obstruction in newborns need urgent paediatric care?",
                    "kind": "action"
                  },
                  {
                    "text": "Is the presentation routing to clinicians first?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "understand",
        "name": "Understand",
        "description": "The condition.",
        "rationale": "Clinical.",
        "layers": [
          {
            "id": "causes",
            "name": "Causes",
            "description": "Causes.",
            "findings": [
              {
                "id": "causes-finding",
                "name": "Causes",
                "description": "Causes.",
                "questions": [
                  {
                    "text": "What causes bowel obstruction, from adhesions and hernias to tumours, volvulus and impaction?",
                    "kind": "definition"
                  },
                  {
                    "text": "Is the question about mechanical obstruction, ileus or constipation?",
                    "kind": "boundary"
                  }
                ]
              }
            ]
          },
          {
            "id": "forms",
            "name": "Forms",
            "description": "Forms.",
            "findings": [
              {
                "id": "forms-finding",
                "name": "Forms",
                "description": "Forms.",
                "questions": [
                  {
                    "text": "How do small bowel, large bowel, duodenal and neonatal obstruction and distal intestinal obstruction syndrome differ?",
                    "kind": "definition"
                  },
                  {
                    "text": "Which entry fits the specific form?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "care",
        "name": "Care",
        "description": "Diagnosis and management.",
        "rationale": "Clinical.",
        "layers": [
          {
            "id": "diagnosis",
            "name": "Diagnosis",
            "description": "Diagnosis.",
            "findings": [
              {
                "id": "diagnosis-finding",
                "name": "Diagnosis",
                "description": "Diagnosis.",
                "questions": [
                  {
                    "text": "How is obstruction diagnosed by examination, X-ray and CT?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which references are standard?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          },
          {
            "id": "management",
            "name": "Management",
            "description": "Management.",
            "findings": [
              {
                "id": "management-finding",
                "name": "Management",
                "description": "Management.",
                "questions": [
                  {
                    "text": "How is obstruction managed with decompression, fluids and surgery, in general terms?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which sources are cited?",
                    "kind": "provenance"
                  }
                ]
              }
            ]
          }
        ]
      },
      {
        "id": "context",
        "name": "Context",
        "description": "Prevention and outcomes.",
        "rationale": "Context.",
        "layers": [
          {
            "id": "prevention",
            "name": "Prevention",
            "description": "Prevention.",
            "findings": [
              {
                "id": "prevention-finding",
                "name": "Prevention",
                "description": "Prevention.",
                "questions": [
                  {
                    "text": "How are adhesions and recurrent obstruction reduced, in general terms?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits surgical adhesion?",
                    "kind": "action"
                  }
                ]
              }
            ]
          },
          {
            "id": "outcomes",
            "name": "Outcomes",
            "description": "Outcomes.",
            "findings": [
              {
                "id": "outcomes-finding",
                "name": "Outcomes",
                "description": "Outcomes.",
                "questions": [
                  {
                    "text": "What are the outcomes and complications of bowel obstruction, as studies report?",
                    "kind": "provenance"
                  },
                  {
                    "text": "Which entry fits bowel ischaemia?",
                    "kind": "action"
                  }
                ]
              }
            ]
          }
        ]
      }
    ]
  },
  "openQuestions": [
    "Should small bowel obstruction and volvulus be separate primary entries?",
    "How should surgical guidelines be linked?",
    "The registry entry has merged aliases naming causes and special forms; should they be split off?"
  ],
  "statistics": {
    "bundles": 4,
    "layers": 8,
    "findings": 8,
    "questions": 16
  }
}