Reviewer ’s report  
 
Title: Case report: Acute abdominal pain in a 37 -year-old patient and the consequences for 
his family  
 
Version: 2 Date: 18 Jan 2020  
 
Revi ewer: Hugo Pinheiro  
 
Reviewer's report:  
 
Dear Editor of BMC Gastroenterology,  
 
In the manuscript "Case report: Acute abdomen in a 37 -year-old patient and the consequences 
for his family", Niemeyer E. et al, present a less typical presentation of HDGC.  
The case reported highlights the importance of recognizing the features of HDGC an d of 
performing genetic testing under the updated HDGC testing criteria.  
Despite the poor outcome for the index patient the strategy described helped not only 
mutation carriers and respective progeny but also the relatives not carrying the mutation who 
are not at increased risk for gastric cancer.  
As only criticism, and although of limited relevance for the work presented, the methodology 
for the IHC for E -cadherin stain or at least the description of the antibody should be 
mentioned.  
Overal, the manuscrip t is clearly written and presents enough detail and information to 
support the conclusions drawn.  
The novelty resides essentially on the form of presentation of the index case and serves as 
reminder of currently available HDGC management strategies.  
 
 
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 neces sary 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 t o 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:  
 
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 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 interests' 
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 w ebsite 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: Case report: Acute abdominal pain in a 37 -year-old patient and the consequences for 
his family  
 
Version: 2 Date: 18 Jan 2020  
 
Revi ewer: Hugo Pinheiro  
 
Reviewer's report:  
 
Dear Editor of BMC Gastroenterology,  
 
In the manuscript "Case report: Acute abdomen in a 37 -year-old patient and the consequences 
for his family", Niemeyer E. et al, present a less typical presentation of HDGC.  
The case reported highlights the importance of recognizing the features of HDGC an d of 
performing genetic testing under the updated HDGC testing criteria.  
Despite the poor outcome for the index patient the strategy described helped not only 
mutation carriers and respective progeny but also the relatives not carrying the mutation who 
are not at increased risk for gastric cancer.  
As only criticism, and although of limited relevance for the work presented, the methodology 
for the IHC for E -cadherin stain or at least the description of the antibody should be 
mentioned.  
Overal, the manuscrip t is clearly written and presents enough detail and information to 
support the conclusions drawn.  
The novelty resides essentially on the form of presentation of the index case and serves as 
reminder of currently available HDGC management strategies.  
 
 
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 neces sary 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 t o 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:  
 
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 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 interests' 
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 w ebsite 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: Case report: Acute abdominal pain in a 37 -year-old patient and the consequences for 
his family  
 
Version: 2 Date: 18 Jan 2020  
 
Revi ewer: Hugo Pinheiro  
 
Reviewer's report:  
 
Dear Editor of BMC Gastroenterology,  
 
In the manuscript "Case report: Acute abdomen in a 37 -year-old patient and the consequences 
for his family", Niemeyer E. et al, present a less typical presentation of HDGC.  
The case reported highlights the importance of recognizing the features of HDGC an d of 
performing genetic testing under the updated HDGC testing criteria.  
Despite the poor outcome for the index patient the strategy described helped not only 
mutation carriers and respective progeny but also the relatives not carrying the mutation who 
are not at increased risk for gastric cancer.  
As only criticism, and although of limited relevance for the work presented, the methodology 
for the IHC for E -cadherin stain or at least the description of the antibody should be 
mentioned.  
Overal, the manuscrip t is clearly written and presents enough detail and information to 
support the conclusions drawn.  
The novelty resides essentially on the form of presentation of the index case and serves as 
reminder of currently available HDGC management strategies.  
 
 
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 neces sary 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 t o 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:  
 
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 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 interests' 
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 w ebsite 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