Reviewer's report
Title:A therapeutic barium enema is a practical option to control bleeding from
the appendix
Version: 2Date:19 March 2013
Reviewer: nonthalee pausawasdi
Reviewer's report:
Major Compulsory Revisions
The manuscript by Konno et al. entitled “'A therapeutic barium enema is a
practical option to control bleeding from the appendix” presents a case of an
elderly male patient with appendiceal bleeding who was treated by injection of
200ml of 50W/V% barium into the orifice of the appendix using a spraying tube.
The authors proposed that bleeding stopped after such therapy and the patient
underwent appendectomy 2 weeks later to prevent recurrent bleeding. The
surgical specimen revealed an ulcer. No complications have been reported.
If bleeding was truly stopped due to the effect of barium without any
complication, this finding is perhaps noteworthy. However, more data are needed
before we can conclude that this is the case. Some issues should be addressed
or discussed to increase the strength of the paper.
These are listed below:
1. Was the anti-coagulant stopped on presentation? If so, this could have been
an important factor on hemostasis which the authors should discuss. And if it was
stopped, when was it restarted?
2. Was the barium injected or sprayed into the appendiceal orifice?
3. Can the authors comment on why you have chosen such volume and density
of barium in the study? Can you choose a high-density barium which have been
reported to be effective in controlling diverticular bleeding?
4. Many studies have demonstrated that barium remains in the diverticula for
more than 24 hours when used as therapeutic modality for diverticular bleeding.
Can authors explain why barium disappears relatively quickly in your study?
Minor Essential Revisions
1. Under case presentation, line 17 “but” does not need to be highlighted
2. Fig legend, Fig 3; “timorous”# should be tumorous
Level of interest: An article of limited interest
Quality of written English: Acceptable
Reviewer's report
Title:A therapeutic barium enema is a practical option to control bleeding from
the appendix
Version: 2Date:19 March 2013
Reviewer: nonthalee pausawasdi
Reviewer's report:
Major Compulsory Revisions
The manuscript by Konno et al. entitled “'A therapeutic barium enema is a
practical option to control bleeding from the appendix” presents a case of an
elderly male patient with appendiceal bleeding who was treated by injection of
200ml of 50W/V% barium into the orifice of the appendix using a spraying tube.
The authors proposed that bleeding stopped after such therapy and the patient
underwent appendectomy 2 weeks later to prevent recurrent bleeding. The
surgical specimen revealed an ulcer. No complications have been reported.
If bleeding was truly stopped due to the effect of barium without any
complication, this finding is perhaps noteworthy. However, more data are needed
before we can conclude that this is the case. Some issues should be addressed
or discussed to increase the strength of the paper.
These are listed below:
1. Was the anti-coagulant stopped on presentation? If so, this could have been
an important factor on hemostasis which the authors should discuss. And if it was
stopped, when was it restarted?
2. Was the barium injected or sprayed into the appendiceal orifice?
3. Can the authors comment on why you have chosen such volume and density
of barium in the study? Can you choose a high-density barium which have been
reported to be effective in controlling diverticular bleeding?
4. Many studies have demonstrated that barium remains in the diverticula for
more than 24 hours when used as therapeutic modality for diverticular bleeding.
Can authors explain why barium disappears relatively quickly in your study?
Minor Essential Revisions
1. Under case presentation, line 17 “but” does not need to be highlighted
2. Fig legend, Fig 3; “timorous”# should be tumorous
Level of interest: An article of limited interest
Quality of written English: Acceptable
Please review this paper.
user
Reviewer's report
Title:A therapeutic barium enema is a practical option to control bleeding from
the appendix
Version: 2Date:19 March 2013
Reviewer: nonthalee pausawasdi
Reviewer's report:
Major Compulsory Revisions
The manuscript by Konno et al. entitled “'A therapeutic barium enema is a
practical option to control bleeding from the appendix” presents a case of an
elderly male patient with appendiceal bleeding who was treated by injection of
200ml of 50W/V% barium into the orifice of the appendix using a spraying tube.
The authors proposed that bleeding stopped after such therapy and the patient
underwent appendectomy 2 weeks later to prevent recurrent bleeding. The
surgical specimen revealed an ulcer. No complications have been reported.
If bleeding was truly stopped due to the effect of barium without any
complication, this finding is perhaps noteworthy. However, more data are needed
before we can conclude that this is the case. Some issues should be addressed
or discussed to increase the strength of the paper.
These are listed below:
1. Was the anti-coagulant stopped on presentation? If so, this could have been
an important factor on hemostasis which the authors should discuss. And if it was
stopped, when was it restarted?
2. Was the barium injected or sprayed into the appendiceal orifice?
3. Can the authors comment on why you have chosen such volume and density
of barium in the study? Can you choose a high-density barium which have been
reported to be effective in controlling diverticular bleeding?
4. Many studies have demonstrated that barium remains in the diverticula for
more than 24 hours when used as therapeutic modality for diverticular bleeding.
Can authors explain why barium disappears relatively quickly in your study?
Minor Essential Revisions
1. Under case presentation, line 17 “but” does not need to be highlighted
2. Fig legend, Fig 3; “timorous”# should be tumorous
Level of interest: An article of limited interest
Quality of written English: Acceptable
assistant