Reviewer's report 
 Fecopneumothorax and colopleural fistula - uncommon complications of Crohn's disease Title: 
 1  8 February 2006 Version: Date: 
 Edward Loftus Reviewer: 
Reviewer's report: 
General 
Barisic and colleagues report a case of a 27 year old woman who presented with fever, dyspnea, 
fatigue, and cough. She was found to have a large hydropneumothorax on the left side, and 
abdominal ultrasound suggested a mass from the colon to the pleural space. Barium enema showed 
a colonic stricture at the splenic flexure and fistula tracts in communication with the left pleural 
space. She underwent splenectomy, colectomy, and Brooke ileostomy. As far as can be determined 
this is the first case report of its kind in Crohn’s disease. 
------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 
1. There are a number of spelling and grammatical errors which should be addressed. The authors should consider enlisting the help of someone who is completely fluent in written English. 2. Please clarify if the patient had a previous diagnosis of Crohn’s disease; if not, please comment 
specifically on whether or not she had experienced gastrointestinal symptoms such as abdominal 
pain, change in bowel habit, or rectal bleeding in the days or weeks leading up to her emergent presentation. 3. Please provide body mass index (BMI) of the patient. Please provide the lab work at presentation 
(hemoglobin, leukocytes, platelets, albumin, sed rate or c-reactive protein). 
4. You mention that the feculent smelling pleural fluid was sent for culture, but you don’t comment further on these results. 5. Please provide more information about the pathological findings—was there transmural 
inflammation, were granulomas present, was the colon strictured at the level of the fistulas, etc? 
6. Please provide more information about the patient’s clinical course following surgery. Was she placed on any medications to prevent recurrence? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 7. Page 3: change “fistulous tubes” to “fistula tracts”. “Brook” should be “Brooke”. “Patohistological” 
should be “Histological” or “Pathological”. 
8. Figure legends. Change “lineal” to “splenic”. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article of limited interest Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have received research support from: Procter and Gamble, Celltech, Techlab. 
I have consulted for: Prometheus, UCB, Abbott. 
Reviewer's report 
 Fecopneumothorax and colopleural fistula - uncommon complications of Crohn's disease Title: 
 1  8 February 2006 Version: Date: 
 Edward Loftus Reviewer: 
Reviewer's report: 
General 
Barisic and colleagues report a case of a 27 year old woman who presented with fever, dyspnea, 
fatigue, and cough. She was found to have a large hydropneumothorax on the left side, and 
abdominal ultrasound suggested a mass from the colon to the pleural space. Barium enema showed 
a colonic stricture at the splenic flexure and fistula tracts in communication with the left pleural 
space. She underwent splenectomy, colectomy, and Brooke ileostomy. As far as can be determined 
this is the first case report of its kind in Crohn’s disease. 
------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 
1. There are a number of spelling and grammatical errors which should be addressed. The authors should consider enlisting the help of someone who is completely fluent in written English. 2. Please clarify if the patient had a previous diagnosis of Crohn’s disease; if not, please comment 
specifically on whether or not she had experienced gastrointestinal symptoms such as abdominal 
pain, change in bowel habit, or rectal bleeding in the days or weeks leading up to her emergent presentation. 3. Please provide body mass index (BMI) of the patient. Please provide the lab work at presentation 
(hemoglobin, leukocytes, platelets, albumin, sed rate or c-reactive protein). 
4. You mention that the feculent smelling pleural fluid was sent for culture, but you don’t comment further on these results. 5. Please provide more information about the pathological findings—was there transmural 
inflammation, were granulomas present, was the colon strictured at the level of the fistulas, etc? 
6. Please provide more information about the patient’s clinical course following surgery. Was she placed on any medications to prevent recurrence? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 7. Page 3: change “fistulous tubes” to “fistula tracts”. “Brook” should be “Brooke”. “Patohistological” 
should be “Histological” or “Pathological”. 
8. Figure legends. Change “lineal” to “splenic”. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article of limited interest Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have received research support from: Procter and Gamble, Celltech, Techlab. 
I have consulted for: Prometheus, UCB, Abbott. 
Please review this paper.
user
Reviewer's report 
 Fecopneumothorax and colopleural fistula - uncommon complications of Crohn's disease Title: 
 1  8 February 2006 Version: Date: 
 Edward Loftus Reviewer: 
Reviewer's report: 
General 
Barisic and colleagues report a case of a 27 year old woman who presented with fever, dyspnea, 
fatigue, and cough. She was found to have a large hydropneumothorax on the left side, and 
abdominal ultrasound suggested a mass from the colon to the pleural space. Barium enema showed 
a colonic stricture at the splenic flexure and fistula tracts in communication with the left pleural 
space. She underwent splenectomy, colectomy, and Brooke ileostomy. As far as can be determined 
this is the first case report of its kind in Crohn’s disease. 
------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can 
be reached) 
1. There are a number of spelling and grammatical errors which should be addressed. The authors should consider enlisting the help of someone who is completely fluent in written English. 2. Please clarify if the patient had a previous diagnosis of Crohn’s disease; if not, please comment 
specifically on whether or not she had experienced gastrointestinal symptoms such as abdominal 
pain, change in bowel habit, or rectal bleeding in the days or weeks leading up to her emergent presentation. 3. Please provide body mass index (BMI) of the patient. Please provide the lab work at presentation 
(hemoglobin, leukocytes, platelets, albumin, sed rate or c-reactive protein). 
4. You mention that the feculent smelling pleural fluid was sent for culture, but you don’t comment further on these results. 5. Please provide more information about the pathological findings—was there transmural 
inflammation, were granulomas present, was the colon strictured at the level of the fistulas, etc? 
6. Please provide more information about the patient’s clinical course following surgery. Was she placed on any medications to prevent recurrence? 
------------------------------------------------------------------------------- 
Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author can be trusted to correct) 7. Page 3: change “fistulous tubes” to “fistula tracts”. “Brook” should be “Brooke”. “Patohistological” 
should be “Histological” or “Pathological”. 
8. Figure legends. Change “lineal” to “splenic”. 
------------------------------------------------------------------------------- 
Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article of limited interest Level of interest: 
 Needs some language corrections before being published Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I have received research support from: Procter and Gamble, Celltech, Techlab. 
I have consulted for: Prometheus, UCB, Abbott. 
assistant