Reviewer's report
Title:Acute gastric dilatation due to a superior mesenteric artery syndrome : an
autopsy case
Version: 1Date:3 May 2013
Reviewer: Yong Sung Kim
Reviewer's report:
This paper reported unusual case of acute gastric dilatation.
It was very interesting case, however there were several issues to be pointed.
Major
1. Please comment that there was no other possible cause of death in the
autopsy. When she was found dead, a large amount of dark brown vomit was
found on the floor around her. As a clinician, I supect the possibility of asphyxia
by vomitus. Is there any evidence of asphyxia in the autopsy?
2. Authors described that "For the cause of the gastric dilation, intestinal
occlusion by the SMA at the third portion of duodenum was suspected."
However, she had never complained symptoms suggesting SMA syndrome. And
duodenum distal to SMA seemed to somewhat dilated in figure 2.
So I think that excessive eating of large food was main cause of gastric dilatation
and the narrowing duodenum (not occlusion) could be a aggravation factor for
gastric dilatation, not leading cause.
I agree wiht author's summary "an excessively large mass of food in the
narrowed duodenal lumen also promoted the development of acute gastric
dilatation in this case of SMA syndrome"
3. Authors described that "The root of the mesentery was thickened and adhered
to the duodenum, which also reduced the duodenal motility (Fig.2). In addition to
these findings, a reduction of peristalsis in the duodenum might have enhanced
gastric dilatation in this case."
Howevere, it cannot be assumed whether "motility" or "peristatlsis" was really
impaired by thickened mesentery by only autopsy finding in this patient .
In addition, she had no previous gastrointestinal symptoms and was well
nourished.
Autopsy finding just showed narrowing of duodenum by thickened mesentery and
SMA.
Thank you
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competeing interests
Reviewer's report
Title:Acute gastric dilatation due to a superior mesenteric artery syndrome : an
autopsy case
Version: 1Date:3 May 2013
Reviewer: Yong Sung Kim
Reviewer's report:
This paper reported unusual case of acute gastric dilatation.
It was very interesting case, however there were several issues to be pointed.
Major
1. Please comment that there was no other possible cause of death in the
autopsy. When she was found dead, a large amount of dark brown vomit was
found on the floor around her. As a clinician, I supect the possibility of asphyxia
by vomitus. Is there any evidence of asphyxia in the autopsy?
2. Authors described that "For the cause of the gastric dilation, intestinal
occlusion by the SMA at the third portion of duodenum was suspected."
However, she had never complained symptoms suggesting SMA syndrome. And
duodenum distal to SMA seemed to somewhat dilated in figure 2.
So I think that excessive eating of large food was main cause of gastric dilatation
and the narrowing duodenum (not occlusion) could be a aggravation factor for
gastric dilatation, not leading cause.
I agree wiht author's summary "an excessively large mass of food in the
narrowed duodenal lumen also promoted the development of acute gastric
dilatation in this case of SMA syndrome"
3. Authors described that "The root of the mesentery was thickened and adhered
to the duodenum, which also reduced the duodenal motility (Fig.2). In addition to
these findings, a reduction of peristalsis in the duodenum might have enhanced
gastric dilatation in this case."
Howevere, it cannot be assumed whether "motility" or "peristatlsis" was really
impaired by thickened mesentery by only autopsy finding in this patient .
In addition, she had no previous gastrointestinal symptoms and was well
nourished.
Autopsy finding just showed narrowing of duodenum by thickened mesentery and
SMA.
Thank you
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competeing interests
Please review this paper.
user
Reviewer's report
Title:Acute gastric dilatation due to a superior mesenteric artery syndrome : an
autopsy case
Version: 1Date:3 May 2013
Reviewer: Yong Sung Kim
Reviewer's report:
This paper reported unusual case of acute gastric dilatation.
It was very interesting case, however there were several issues to be pointed.
Major
1. Please comment that there was no other possible cause of death in the
autopsy. When she was found dead, a large amount of dark brown vomit was
found on the floor around her. As a clinician, I supect the possibility of asphyxia
by vomitus. Is there any evidence of asphyxia in the autopsy?
2. Authors described that "For the cause of the gastric dilation, intestinal
occlusion by the SMA at the third portion of duodenum was suspected."
However, she had never complained symptoms suggesting SMA syndrome. And
duodenum distal to SMA seemed to somewhat dilated in figure 2.
So I think that excessive eating of large food was main cause of gastric dilatation
and the narrowing duodenum (not occlusion) could be a aggravation factor for
gastric dilatation, not leading cause.
I agree wiht author's summary "an excessively large mass of food in the
narrowed duodenal lumen also promoted the development of acute gastric
dilatation in this case of SMA syndrome"
3. Authors described that "The root of the mesentery was thickened and adhered
to the duodenum, which also reduced the duodenal motility (Fig.2). In addition to
these findings, a reduction of peristalsis in the duodenum might have enhanced
gastric dilatation in this case."
Howevere, it cannot be assumed whether "motility" or "peristatlsis" was really
impaired by thickened mesentery by only autopsy finding in this patient .
In addition, she had no previous gastrointestinal symptoms and was well
nourished.
Autopsy finding just showed narrowing of duodenum by thickened mesentery and
SMA.
Thank you
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I have no competeing interests
assistant