Reviewer ’s report  
 
Title: Obstructive jaundice due to a blood clot after ERCP: a case report and review of the 
literature  
 
Version: 1 Date: 13 Dec 2017  
 
Reviewer: Law Jeremy Law  
 
Reviewer's report:  
 
Zhu et al. present a case report of a blood clot causing bile duct obstruction after index ERCP w/ 
sphincterotomy. Additionally, they provide a lit erature review of four prior case reports 
describing a similar phenomenon.  
 
Minor Comments:  
- Please avoid using the term "complications." The term "adverse events" should be used 
instead.  
 
- Several spelling and grammar errors are evident and should be corr ected.  
 
- Did the patient have any GI bleeding after the initial ERCP? Was the blood clot thought to be 
related to post -sphincterotomy bleeding?  
 
- Was there a drop in hemoglobin after the initial ERCP?  
 
Major Comments:  
- The authors should describe scenarios in which clinicians should suspect this etiology as the 
cause of biliary obstruction.  
Are the methods appropriate and well described?  
If not, please specify  what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
  
Are the conclusions drawn adequately supp orted by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections befor e being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that m ay in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either  now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating  to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing i nterests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the  manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Obstructive jaundice due to a blood clot after ERCP: a case report and review of the 
literature  
 
Version: 1 Date: 13 Dec 2017  
 
Reviewer: Law Jeremy Law  
 
Reviewer's report:  
 
Zhu et al. present a case report of a blood clot causing bile duct obstruction after index ERCP w/ 
sphincterotomy. Additionally, they provide a lit erature review of four prior case reports 
describing a similar phenomenon.  
 
Minor Comments:  
- Please avoid using the term "complications." The term "adverse events" should be used 
instead.  
 
- Several spelling and grammar errors are evident and should be corr ected.  
 
- Did the patient have any GI bleeding after the initial ERCP? Was the blood clot thought to be 
related to post -sphincterotomy bleeding?  
 
- Was there a drop in hemoglobin after the initial ERCP?  
 
Major Comments:  
- The authors should describe scenarios in which clinicians should suspect this etiology as the 
cause of biliary obstruction.  
Are the methods appropriate and well described?  
If not, please specify  what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
  
Are the conclusions drawn adequately supp orted by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections befor e being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that m ay in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either  now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating  to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing i nterests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the  manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Obstructive jaundice due to a blood clot after ERCP: a case report and review of the 
literature  
 
Version: 1 Date: 13 Dec 2017  
 
Reviewer: Law Jeremy Law  
 
Reviewer's report:  
 
Zhu et al. present a case report of a blood clot causing bile duct obstruction after index ERCP w/ 
sphincterotomy. Additionally, they provide a lit erature review of four prior case reports 
describing a similar phenomenon.  
 
Minor Comments:  
- Please avoid using the term "complications." The term "adverse events" should be used 
instead.  
 
- Several spelling and grammar errors are evident and should be corr ected.  
 
- Did the patient have any GI bleeding after the initial ERCP? Was the blood clot thought to be 
related to post -sphincterotomy bleeding?  
 
- Was there a drop in hemoglobin after the initial ERCP?  
 
Major Comments:  
- The authors should describe scenarios in which clinicians should suspect this etiology as the 
cause of biliary obstruction.  
Are the methods appropriate and well described?  
If not, please specify  what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
  
Are the conclusions drawn adequately supp orted by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections befor e being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that m ay in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either  now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating  to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing i nterests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the  manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant