Reviewer's report
Title:Frequency and risk factors for rebleeding events in patients with small
bowel angioectasia
Version:1Date:25 June 2014
Reviewer: István Rácz
Reviewer's report:
Comments to the authors
It is excellent paper reporting that how difficult is to find and to treat
endoscopically small bowel angiectasias causing permament or intermittent
bleedings. The authors in 68 patients performed balloon enteroscopy and in 22
patients APC treatment of the angiectasias were done. All angiectasias were
previously (within 5 days) detected by CE.
In 46 angiectasia patients proved both by CE and enteroscopy no interventional
treatment was performed. All patients were followed up for one year. There was
no significant difference in the one year rebleeding rates comparing the APC
treatment and the conservative treated groups. The authors conclude that one
single session of endoscopic treatment by APC for small bowel is not sufficient to
prevent future rebleedings.
Although the paper is very informative several questions may arise:
1. The authors in 74 patient detected angiectasias by CE. All these patients
underwent enteroscopy? Could the authors confirm the CE results by
enteroscopy in all patients?
2. Could the authors measure or estimate the size (diameter) of the
angiectasias? If yes, were any tendency of higher rebleeding rates in larger
angiodyplasias when compared with the smaller ones?
3. What kind of thermal energy (Watts) were used for APC shots?
4. How do the authors comment that ongoing anticoagulant treatment was not
predictor for rebleeding?
5. How does the aspirin (even low dose) therapy affected the rebleeding rates?
Aspirin has not the same effect in the small bowel like NSAIDs.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Reviewer's report
Title:Frequency and risk factors for rebleeding events in patients with small
bowel angioectasia
Version:1Date:25 June 2014
Reviewer: István Rácz
Reviewer's report:
Comments to the authors
It is excellent paper reporting that how difficult is to find and to treat
endoscopically small bowel angiectasias causing permament or intermittent
bleedings. The authors in 68 patients performed balloon enteroscopy and in 22
patients APC treatment of the angiectasias were done. All angiectasias were
previously (within 5 days) detected by CE.
In 46 angiectasia patients proved both by CE and enteroscopy no interventional
treatment was performed. All patients were followed up for one year. There was
no significant difference in the one year rebleeding rates comparing the APC
treatment and the conservative treated groups. The authors conclude that one
single session of endoscopic treatment by APC for small bowel is not sufficient to
prevent future rebleedings.
Although the paper is very informative several questions may arise:
1. The authors in 74 patient detected angiectasias by CE. All these patients
underwent enteroscopy? Could the authors confirm the CE results by
enteroscopy in all patients?
2. Could the authors measure or estimate the size (diameter) of the
angiectasias? If yes, were any tendency of higher rebleeding rates in larger
angiodyplasias when compared with the smaller ones?
3. What kind of thermal energy (Watts) were used for APC shots?
4. How do the authors comment that ongoing anticoagulant treatment was not
predictor for rebleeding?
5. How does the aspirin (even low dose) therapy affected the rebleeding rates?
Aspirin has not the same effect in the small bowel like NSAIDs.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Please review this paper.
user
Reviewer's report
Title:Frequency and risk factors for rebleeding events in patients with small
bowel angioectasia
Version:1Date:25 June 2014
Reviewer: István Rácz
Reviewer's report:
Comments to the authors
It is excellent paper reporting that how difficult is to find and to treat
endoscopically small bowel angiectasias causing permament or intermittent
bleedings. The authors in 68 patients performed balloon enteroscopy and in 22
patients APC treatment of the angiectasias were done. All angiectasias were
previously (within 5 days) detected by CE.
In 46 angiectasia patients proved both by CE and enteroscopy no interventional
treatment was performed. All patients were followed up for one year. There was
no significant difference in the one year rebleeding rates comparing the APC
treatment and the conservative treated groups. The authors conclude that one
single session of endoscopic treatment by APC for small bowel is not sufficient to
prevent future rebleedings.
Although the paper is very informative several questions may arise:
1. The authors in 74 patient detected angiectasias by CE. All these patients
underwent enteroscopy? Could the authors confirm the CE results by
enteroscopy in all patients?
2. Could the authors measure or estimate the size (diameter) of the
angiectasias? If yes, were any tendency of higher rebleeding rates in larger
angiodyplasias when compared with the smaller ones?
3. What kind of thermal energy (Watts) were used for APC shots?
4. How do the authors comment that ongoing anticoagulant treatment was not
predictor for rebleeding?
5. How does the aspirin (even low dose) therapy affected the rebleeding rates?
Aspirin has not the same effect in the small bowel like NSAIDs.
Level of interest: An article of outstanding merit and interest in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
assistant