Reviewer's report
Title:Cerebral Air Embolism as a Complication of Peptic Ulcer in the Gastric
Tube: Case report
Version: 1Date:18 September 2011
Reviewer: Patrick Yachimski
Reviewer's report:
The authors present a case report of cerebral air embolism due to a perforated
gastric conduit ulcer into the pulmonary vein. This is an unusual presentation of a
devastating (and ultimately fatal) clinical problem in a patient with surgically
altered anatomy.
The report is described in clear and concise fashion, and the manuscript reads
easily.
I would recommend these minor revisions:
1) Case presentation: not sure how the elevated C-reactive protein is helpful in
diagnosis or management, this detail can be omitted from the manuscript
2) The ulcer is described as a UL-IV ulcer--not all readers may be familiar with
this classification, so this needs to be described in detail.
3) Not sure why the CD34 immunostaining is important--wasn't penetration of the
ulcer into the pulmonary vein already evident?
4) Conclusion: the recommendation of endoscopic surveillance and PPI
treatment for peptic ulcers is certainly reasonable, but I'm not convinced that this
conclusion is supported by your manuscript--a more appropriate conclusion,
based on the presented case, might be something like: "Cerebral air embolism is
a rare complication of penetrating gastric ulcer, but should be considered in
patients with a history of esophagectomy with gastric conduit and who presented
with acute neurologic findings."
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Cerebral Air Embolism as a Complication of Peptic Ulcer in the Gastric
Tube: Case report
Version: 1Date:18 September 2011
Reviewer: Patrick Yachimski
Reviewer's report:
The authors present a case report of cerebral air embolism due to a perforated
gastric conduit ulcer into the pulmonary vein. This is an unusual presentation of a
devastating (and ultimately fatal) clinical problem in a patient with surgically
altered anatomy.
The report is described in clear and concise fashion, and the manuscript reads
easily.
I would recommend these minor revisions:
1) Case presentation: not sure how the elevated C-reactive protein is helpful in
diagnosis or management, this detail can be omitted from the manuscript
2) The ulcer is described as a UL-IV ulcer--not all readers may be familiar with
this classification, so this needs to be described in detail.
3) Not sure why the CD34 immunostaining is important--wasn't penetration of the
ulcer into the pulmonary vein already evident?
4) Conclusion: the recommendation of endoscopic surveillance and PPI
treatment for peptic ulcers is certainly reasonable, but I'm not convinced that this
conclusion is supported by your manuscript--a more appropriate conclusion,
based on the presented case, might be something like: "Cerebral air embolism is
a rare complication of penetrating gastric ulcer, but should be considered in
patients with a history of esophagectomy with gastric conduit and who presented
with acute neurologic findings."
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Cerebral Air Embolism as a Complication of Peptic Ulcer in the Gastric
Tube: Case report
Version: 1Date:18 September 2011
Reviewer: Patrick Yachimski
Reviewer's report:
The authors present a case report of cerebral air embolism due to a perforated
gastric conduit ulcer into the pulmonary vein. This is an unusual presentation of a
devastating (and ultimately fatal) clinical problem in a patient with surgically
altered anatomy.
The report is described in clear and concise fashion, and the manuscript reads
easily.
I would recommend these minor revisions:
1) Case presentation: not sure how the elevated C-reactive protein is helpful in
diagnosis or management, this detail can be omitted from the manuscript
2) The ulcer is described as a UL-IV ulcer--not all readers may be familiar with
this classification, so this needs to be described in detail.
3) Not sure why the CD34 immunostaining is important--wasn't penetration of the
ulcer into the pulmonary vein already evident?
4) Conclusion: the recommendation of endoscopic surveillance and PPI
treatment for peptic ulcers is certainly reasonable, but I'm not convinced that this
conclusion is supported by your manuscript--a more appropriate conclusion,
based on the presented case, might be something like: "Cerebral air embolism is
a rare complication of penetrating gastric ulcer, but should be considered in
patients with a history of esophagectomy with gastric conduit and who presented
with acute neurologic findings."
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.
assistant