Reviewer ’s report  
 
Title: Bleeding 'downhill' esophageal varices associated with benign superior vena cava 
obstruction: case report and literature review  
 
 
Version: 0 Date: 05 Aug 2016  
 
 
Reviewer: R.C. Verdonk  
 
Reviewer's report:  
 
1. This paper describes a rare entity, that an endoscopist encounters a few times in his or her 
carreer. It is a rare and complex entity.  
 
2. The paper is relevant and well written.  
 
3. I have 3 comments that could be considered by the authors:  
A. Is the re any literature on the role of pharmacotherapy in treating proximal varices? Probably 
not. Please include a short section on the role of octreotide/PPI's etc. This is relevant to clinicians 
reading this paper because they are confronted with a similar pa tient.  
B. I think it should be stressed that on the basis of the current literature, an advice on endoscopic 
therapy (efficacy, safety, which modality) can not be made.  
C. It is not clear which search strategy the authors deployed to collect the literature  stated in the 
table. Please consider a short section describing this.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported 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 manuscrip  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 may 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 fut ure? 
 
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 interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare tha t 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 m y 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: Bleeding 'downhill' esophageal varices associated with benign superior vena cava 
obstruction: case report and literature review  
 
 
Version: 0 Date: 05 Aug 2016  
 
 
Reviewer: R.C. Verdonk  
 
Reviewer's report:  
 
1. This paper describes a rare entity, that an endoscopist encounters a few times in his or her 
carreer. It is a rare and complex entity.  
 
2. The paper is relevant and well written.  
 
3. I have 3 comments that could be considered by the authors:  
A. Is the re any literature on the role of pharmacotherapy in treating proximal varices? Probably 
not. Please include a short section on the role of octreotide/PPI's etc. This is relevant to clinicians 
reading this paper because they are confronted with a similar pa tient.  
B. I think it should be stressed that on the basis of the current literature, an advice on endoscopic 
therapy (efficacy, safety, which modality) can not be made.  
C. It is not clear which search strategy the authors deployed to collect the literature  stated in the 
table. Please consider a short section describing this.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported 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 manuscrip  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 may 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 fut ure? 
 
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 interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare tha t 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 m y 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: Bleeding 'downhill' esophageal varices associated with benign superior vena cava 
obstruction: case report and literature review  
 
 
Version: 0 Date: 05 Aug 2016  
 
 
Reviewer: R.C. Verdonk  
 
Reviewer's report:  
 
1. This paper describes a rare entity, that an endoscopist encounters a few times in his or her 
carreer. It is a rare and complex entity.  
 
2. The paper is relevant and well written.  
 
3. I have 3 comments that could be considered by the authors:  
A. Is the re any literature on the role of pharmacotherapy in treating proximal varices? Probably 
not. Please include a short section on the role of octreotide/PPI's etc. This is relevant to clinicians 
reading this paper because they are confronted with a similar pa tient.  
B. I think it should be stressed that on the basis of the current literature, an advice on endoscopic 
therapy (efficacy, safety, which modality) can not be made.  
C. It is not clear which search strategy the authors deployed to collect the literature  stated in the 
table. Please consider a short section describing this.  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported 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 manuscrip  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
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 may 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 fut ure? 
 
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 interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare tha t 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 m y 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