Reviewer ’s report  
Title: Stercoral colitis complicated with Ischemic colitis: A double -edge sword  
 
Version: 0 Date: 19 Feb 2017  
 
Reviewer: Daisuke Masuda  
 
Reviewer's report:  
Authors described a case report of 'Ischemic colitis concomitant with stercoral colitis'.  Ischemic 
colitis with stercoral colitis is rare and serious inflammatory co ndition, if left undiagnosed or if 
not treated aggressively, focal ulceration can arise, leading to perforation, peritonitis, and septic shock
 eventually causing death.  That is why early diagnosis and aggressive treatment with bowel cleansing 
and fecal disimpaction is essential to avoid the fatal consequence of such a condition. This case report 
is interesting, but clinically above points are common and not so attractive. Authors should show 
similar cases review and discuss similar points and different points compared with other reports and 
explain several points..  
 
Major comments  
1. Authors described 'ischemic colitis with stercoral colitis is rare and serious inflammatory 
condition, if left undiagnosed or if not treated aggressively, focal ulceration can arise, leading 
to perforation, peritonitis, and septic shock eventually causi ng death' in this paper.  Authors 
should review similar cases and discuss similar points and different points compared with 
other reports.  
 
2. How does author think definition of 'ischemic colitis' and 'colonic ischemia'?  Both are same 
meaning or differe nt?  
 
3. What do authors think the pathophysiological mechanism of this case although author 
described about this respect in 'Discussion'?  This present case had ischemic colitis in 
advance before occurring stercoral colitis or stercoral colitis resulted i n colonic ischemia? 
Author should discuss about points.  
4. Author insist on necessity of aggressive treatment of stercoral colitis with ischemic colitis, 
but aggressive treatment can be performed safely for stercoral colitis and ischemic colitis 
with imp acted stools in co -mobid elderly patients?  Fortunately perforation was recognized in 
present case, but how does author consider risk of perforation by performing aggressive 
treatment?  
 
Minor comments  
1. Colonoscopy image is edema, erythema and ulceration,  where is extend of these findings?  
2. If this case had ischemic colitis, authors should show more common colonoscopic image of 
ischemic colitis.   
3. Author should use correct literal medical English for paper publishment.   
 
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 adequa tely supported by the data shown?  
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommende d, please specify what aspects require further  
assessment in your comments to the editors.  
Not relevant to this manuscrip t 
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interest s 
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 pub lication 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 cu rrently 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 interest s 
 
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 webs ite 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 nam ed 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: Stercoral colitis complicated with Ischemic colitis: A double -edge sword  
 
Version: 0 Date: 19 Feb 2017  
 
Reviewer: Daisuke Masuda  
 
Reviewer's report:  
Authors described a case report of 'Ischemic colitis concomitant with stercoral colitis'.  Ischemic 
colitis with stercoral colitis is rare and serious inflammatory co ndition, if left undiagnosed or if 
not treated aggressively, focal ulceration can arise, leading to perforation, peritonitis, and septic shock
 eventually causing death.  That is why early diagnosis and aggressive treatment with bowel cleansing 
and fecal disimpaction is essential to avoid the fatal consequence of such a condition. This case report 
is interesting, but clinically above points are common and not so attractive. Authors should show 
similar cases review and discuss similar points and different points compared with other reports and 
explain several points..  
 
Major comments  
1. Authors described 'ischemic colitis with stercoral colitis is rare and serious inflammatory 
condition, if left undiagnosed or if not treated aggressively, focal ulceration can arise, leading 
to perforation, peritonitis, and septic shock eventually causi ng death' in this paper.  Authors 
should review similar cases and discuss similar points and different points compared with 
other reports.  
 
2. How does author think definition of 'ischemic colitis' and 'colonic ischemia'?  Both are same 
meaning or differe nt?  
 
3. What do authors think the pathophysiological mechanism of this case although author 
described about this respect in 'Discussion'?  This present case had ischemic colitis in 
advance before occurring stercoral colitis or stercoral colitis resulted i n colonic ischemia? 
Author should discuss about points.  
4. Author insist on necessity of aggressive treatment of stercoral colitis with ischemic colitis, 
but aggressive treatment can be performed safely for stercoral colitis and ischemic colitis 
with imp acted stools in co -mobid elderly patients?  Fortunately perforation was recognized in 
present case, but how does author consider risk of perforation by performing aggressive 
treatment?  
 
Minor comments  
1. Colonoscopy image is edema, erythema and ulceration,  where is extend of these findings?  
2. If this case had ischemic colitis, authors should show more common colonoscopic image of 
ischemic colitis.   
3. Author should use correct literal medical English for paper publishment.   
 
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 adequa tely supported by the data shown?  
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommende d, please specify what aspects require further  
assessment in your comments to the editors.  
Not relevant to this manuscrip t 
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interest s 
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 pub lication 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 cu rrently 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 interest s 
 
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 webs ite 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 nam ed 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: Stercoral colitis complicated with Ischemic colitis: A double -edge sword  
 
Version: 0 Date: 19 Feb 2017  
 
Reviewer: Daisuke Masuda  
 
Reviewer's report:  
Authors described a case report of 'Ischemic colitis concomitant with stercoral colitis'.  Ischemic 
colitis with stercoral colitis is rare and serious inflammatory co ndition, if left undiagnosed or if 
not treated aggressively, focal ulceration can arise, leading to perforation, peritonitis, and septic shock
 eventually causing death.  That is why early diagnosis and aggressive treatment with bowel cleansing 
and fecal disimpaction is essential to avoid the fatal consequence of such a condition. This case report 
is interesting, but clinically above points are common and not so attractive. Authors should show 
similar cases review and discuss similar points and different points compared with other reports and 
explain several points..  
 
Major comments  
1. Authors described 'ischemic colitis with stercoral colitis is rare and serious inflammatory 
condition, if left undiagnosed or if not treated aggressively, focal ulceration can arise, leading 
to perforation, peritonitis, and septic shock eventually causi ng death' in this paper.  Authors 
should review similar cases and discuss similar points and different points compared with 
other reports.  
 
2. How does author think definition of 'ischemic colitis' and 'colonic ischemia'?  Both are same 
meaning or differe nt?  
 
3. What do authors think the pathophysiological mechanism of this case although author 
described about this respect in 'Discussion'?  This present case had ischemic colitis in 
advance before occurring stercoral colitis or stercoral colitis resulted i n colonic ischemia? 
Author should discuss about points.  
4. Author insist on necessity of aggressive treatment of stercoral colitis with ischemic colitis, 
but aggressive treatment can be performed safely for stercoral colitis and ischemic colitis 
with imp acted stools in co -mobid elderly patients?  Fortunately perforation was recognized in 
present case, but how does author consider risk of perforation by performing aggressive 
treatment?  
 
Minor comments  
1. Colonoscopy image is edema, erythema and ulceration,  where is extend of these findings?  
2. If this case had ischemic colitis, authors should show more common colonoscopic image of 
ischemic colitis.   
3. Author should use correct literal medical English for paper publishment.   
 
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 adequa tely supported by the data shown?  
If not, please explain in your comments to the authors.  
No 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommende d, please specify what aspects require further  
assessment in your comments to the editors.  
Not relevant to this manuscrip t 
Quality of written English  
Please indicate the quality of language in the manuscript:  
Needs some language corrections before being published  
Declaration of competing interest s 
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 pub lication 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 cu rrently 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 interest s 
 
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 webs ite 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 nam ed 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