Reviewer’s report
Title: 
Retrograde Coiled Spring Jejunal Intussusception in an Infant due to Foley
Catheter Gastrostomy: A Case Report
Version: 
0 
Date: 
07 May 2021
Reviewer: 
Michael Pak-Kai Wong
Reviewer's report:
Thank you for the manuscript of this interesting case report. Below are several
comments and suggestions: 
Page 2 Line 24 unite 
Typing error, I think the author meant unit
Page 3 Line 55
Citation format error
Page 3 Line 57
Citation format error
Page 5 Line 103 An
Typing error, I think the author meant "A"
Page 5 Line 104 Regarding Fig. 3
Need to label with an arrow. There are many tubes visible on the AXR. It can be
confusing for the readers.
Page 5 
Line 106-107 serum saline enema
This may be another typing error. Does the author refer to saline enema? 
Page 5 Line 110
Coiled Spring Sign is a fluoroscopic or contrast imaging denoting
intussusception. It is not a specific type of jejunal intussusception. The Coiled
spring sign are visible with bowel contrast study. Suggestion to the author may
consider adding the radiological image with appropriate marker to demonstrate
this coiled spring sign.
Page 5 Line 113 Regarding Fig. 4
The image shown clearly the dilated small bowel arranged in spiral apperance.
However, the site of intussusception are not clearly visualised. Perhaps, the
authors could use the marker to indicate the sites of the intussusceptions as
stated in their manuscript.
Page 5 Line 115 After waiting long enough….
This is a subjective description. Perhaps the authors could explain what they
meant by after waiting long enough. Suggestion: the author may consider
explaining what was actively done for bowel resuscitation during the period of
observation for improvement of the intestinal circulation.
Page 5 Line 124 Discussion and conclusions
The discussion and conclusion should be in separate subheadings
Page 7 Line 153-154
Please provide references to this statement.
Page 7 Line 156-157
This statement appears fragmented, suggest for revision.
Page 7 Line 162-163
The coiled spring sign in intussusception refer to the contrast study - the
appearance occurs when the contrast reflux within the lumen between the
intussusceptum and intussuscipiens.
The author may have misunderstood the sign. However, the author may highlight
on the multiple intussusceptions in one segment of bowel which is an interesting
phenomenon in this case report.
Page 7 Line 167-168
In the references 11-13, the original author did not mention about "coiled spring"
intussusception. However, they mentioned clearly that it was a retrograde
intussusception.
Page 8 Line 184-185
The author described the abdominal examination of the patient. However, a
citation was added at the end of this statement with unclear intention.
The statement of mild abdomen distension and normal bowel sounds with the
ileus is very contradicting. Suggest revising this statement.
Page 9 Line 208-209 A coiled spring intussusception….
Perhaps the author refer to the multiple retrograde intussusception rather than
coiled spring intussusception. This is to avoid confusion to the reader.
Page 10 Line 244 tub
Typing error - tube
Page 10 Line 244 an external bolster 
The author may be referring to "external bumper" on the standard gastrostomy
tube.
If the authors wish to make a recommendation, perhaps a recommendation of
prompt change to a proper gastrostomy tube would be more appropriate. The use
of Foley's catheter is a temporary measure while waiting for the proper
gastrostomy tube replacements.
If the authors wish to make an innovative recommendation, perhaps an example
of the innovation "external bolster or ring" which was stated with pictorial
illustration would be helpful. 
Page 11 Line 269-271
The Foley's catheter is commonly use as a temporary placement to avoid
spontaneous closure of the gastrostomy site when accidental dislodged of the
gastrostomy occur. This is still relevant and useful especially if the patient
presented to the district hospital where the gastrostomy tubes are not easily
available. It was never meant to be permanent usage. There are many different
types of gastrostomy tubes available on the market. It should be replaced as soon
as the gastrostomy tube is available.
This statement is confusing. Suggest to revise or remove if appropriate.
Page 12 Line 274-275
Suggest to use retrograde intussusception and not to use "coiled spring" which
could be misleading to the readers.
Figure 1 - 6
Please add captions and also label the appropriate part with the
markers/indicators. This will ease the reader to appreciate the highlight of your
case.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
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a reviewer by updating your profile published on its webservice if you have
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find the details of processing in Publons’ privacy policy
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Yes
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.
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Reviewer’s report
Title: 
Retrograde Coiled Spring Jejunal Intussusception in an Infant due to Foley
Catheter Gastrostomy: A Case Report
Version: 
0 
Date: 
07 May 2021
Reviewer: 
Michael Pak-Kai Wong
Reviewer's report:
Thank you for the manuscript of this interesting case report. Below are several
comments and suggestions: 
Page 2 Line 24 unite 
Typing error, I think the author meant unit
Page 3 Line 55
Citation format error
Page 3 Line 57
Citation format error
Page 5 Line 103 An
Typing error, I think the author meant "A"
Page 5 Line 104 Regarding Fig. 3
Need to label with an arrow. There are many tubes visible on the AXR. It can be
confusing for the readers.
Page 5 
Line 106-107 serum saline enema
This may be another typing error. Does the author refer to saline enema? 
Page 5 Line 110
Coiled Spring Sign is a fluoroscopic or contrast imaging denoting
intussusception. It is not a specific type of jejunal intussusception. The Coiled
spring sign are visible with bowel contrast study. Suggestion to the author may
consider adding the radiological image with appropriate marker to demonstrate
this coiled spring sign.
Page 5 Line 113 Regarding Fig. 4
The image shown clearly the dilated small bowel arranged in spiral apperance.
However, the site of intussusception are not clearly visualised. Perhaps, the
authors could use the marker to indicate the sites of the intussusceptions as
stated in their manuscript.
Page 5 Line 115 After waiting long enough….
This is a subjective description. Perhaps the authors could explain what they
meant by after waiting long enough. Suggestion: the author may consider
explaining what was actively done for bowel resuscitation during the period of
observation for improvement of the intestinal circulation.
Page 5 Line 124 Discussion and conclusions
The discussion and conclusion should be in separate subheadings
Page 7 Line 153-154
Please provide references to this statement.
Page 7 Line 156-157
This statement appears fragmented, suggest for revision.
Page 7 Line 162-163
The coiled spring sign in intussusception refer to the contrast study - the
appearance occurs when the contrast reflux within the lumen between the
intussusceptum and intussuscipiens.
The author may have misunderstood the sign. However, the author may highlight
on the multiple intussusceptions in one segment of bowel which is an interesting
phenomenon in this case report.
Page 7 Line 167-168
In the references 11-13, the original author did not mention about "coiled spring"
intussusception. However, they mentioned clearly that it was a retrograde
intussusception.
Page 8 Line 184-185
The author described the abdominal examination of the patient. However, a
citation was added at the end of this statement with unclear intention.
The statement of mild abdomen distension and normal bowel sounds with the
ileus is very contradicting. Suggest revising this statement.
Page 9 Line 208-209 A coiled spring intussusception….
Perhaps the author refer to the multiple retrograde intussusception rather than
coiled spring intussusception. This is to avoid confusion to the reader.
Page 10 Line 244 tub
Typing error - tube
Page 10 Line 244 an external bolster 
The author may be referring to "external bumper" on the standard gastrostomy
tube.
If the authors wish to make a recommendation, perhaps a recommendation of
prompt change to a proper gastrostomy tube would be more appropriate. The use
of Foley's catheter is a temporary measure while waiting for the proper
gastrostomy tube replacements.
If the authors wish to make an innovative recommendation, perhaps an example
of the innovation "external bolster or ring" which was stated with pictorial
illustration would be helpful. 
Page 11 Line 269-271
The Foley's catheter is commonly use as a temporary placement to avoid
spontaneous closure of the gastrostomy site when accidental dislodged of the
gastrostomy occur. This is still relevant and useful especially if the patient
presented to the district hospital where the gastrostomy tubes are not easily
available. It was never meant to be permanent usage. There are many different
types of gastrostomy tubes available on the market. It should be replaced as soon
as the gastrostomy tube is available.
This statement is confusing. Suggest to revise or remove if appropriate.
Page 12 Line 274-275
Suggest to use retrograde intussusception and not to use "coiled spring" which
could be misleading to the readers.
Figure 1 - 6
Please add captions and also label the appropriate part with the
markers/indicators. This will ease the reader to appreciate the highlight of your
case.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
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.
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
Please review this paper.
user
Reviewer’s report
Title: 
Retrograde Coiled Spring Jejunal Intussusception in an Infant due to Foley
Catheter Gastrostomy: A Case Report
Version: 
0 
Date: 
07 May 2021
Reviewer: 
Michael Pak-Kai Wong
Reviewer's report:
Thank you for the manuscript of this interesting case report. Below are several
comments and suggestions: 
Page 2 Line 24 unite 
Typing error, I think the author meant unit
Page 3 Line 55
Citation format error
Page 3 Line 57
Citation format error
Page 5 Line 103 An
Typing error, I think the author meant "A"
Page 5 Line 104 Regarding Fig. 3
Need to label with an arrow. There are many tubes visible on the AXR. It can be
confusing for the readers.
Page 5 
Line 106-107 serum saline enema
This may be another typing error. Does the author refer to saline enema? 
Page 5 Line 110
Coiled Spring Sign is a fluoroscopic or contrast imaging denoting
intussusception. It is not a specific type of jejunal intussusception. The Coiled
spring sign are visible with bowel contrast study. Suggestion to the author may
consider adding the radiological image with appropriate marker to demonstrate
this coiled spring sign.
Page 5 Line 113 Regarding Fig. 4
The image shown clearly the dilated small bowel arranged in spiral apperance.
However, the site of intussusception are not clearly visualised. Perhaps, the
authors could use the marker to indicate the sites of the intussusceptions as
stated in their manuscript.
Page 5 Line 115 After waiting long enough….
This is a subjective description. Perhaps the authors could explain what they
meant by after waiting long enough. Suggestion: the author may consider
explaining what was actively done for bowel resuscitation during the period of
observation for improvement of the intestinal circulation.
Page 5 Line 124 Discussion and conclusions
The discussion and conclusion should be in separate subheadings
Page 7 Line 153-154
Please provide references to this statement.
Page 7 Line 156-157
This statement appears fragmented, suggest for revision.
Page 7 Line 162-163
The coiled spring sign in intussusception refer to the contrast study - the
appearance occurs when the contrast reflux within the lumen between the
intussusceptum and intussuscipiens.
The author may have misunderstood the sign. However, the author may highlight
on the multiple intussusceptions in one segment of bowel which is an interesting
phenomenon in this case report.
Page 7 Line 167-168
In the references 11-13, the original author did not mention about "coiled spring"
intussusception. However, they mentioned clearly that it was a retrograde
intussusception.
Page 8 Line 184-185
The author described the abdominal examination of the patient. However, a
citation was added at the end of this statement with unclear intention.
The statement of mild abdomen distension and normal bowel sounds with the
ileus is very contradicting. Suggest revising this statement.
Page 9 Line 208-209 A coiled spring intussusception….
Perhaps the author refer to the multiple retrograde intussusception rather than
coiled spring intussusception. This is to avoid confusion to the reader.
Page 10 Line 244 tub
Typing error - tube
Page 10 Line 244 an external bolster 
The author may be referring to "external bumper" on the standard gastrostomy
tube.
If the authors wish to make a recommendation, perhaps a recommendation of
prompt change to a proper gastrostomy tube would be more appropriate. The use
of Foley's catheter is a temporary measure while waiting for the proper
gastrostomy tube replacements.
If the authors wish to make an innovative recommendation, perhaps an example
of the innovation "external bolster or ring" which was stated with pictorial
illustration would be helpful. 
Page 11 Line 269-271
The Foley's catheter is commonly use as a temporary placement to avoid
spontaneous closure of the gastrostomy site when accidental dislodged of the
gastrostomy occur. This is still relevant and useful especially if the patient
presented to the district hospital where the gastrostomy tubes are not easily
available. It was never meant to be permanent usage. There are many different
types of gastrostomy tubes available on the market. It should be replaced as soon
as the gastrostomy tube is available.
This statement is confusing. Suggest to revise or remove if appropriate.
Page 12 Line 274-275
Suggest to use retrograde intussusception and not to use "coiled spring" which
could be misleading to the readers.
Figure 1 - 6
Please add captions and also label the appropriate part with the
markers/indicators. This will ease the reader to appreciate the highlight of your
case.
Publons Reviewer Recognition
. Springer Nature can send verification of this
review directly to Publons (a subsidiary of Clarivate Analytics). If you would
like to take advantage of this service, please click on the “Yes” option below.
Your name, email address, title of the reviewed manuscript, name of the journal,
and date of your review submission (the “Review Data”) will then be transmitted
to Publons after the final decision on the manuscript has been made. If you have
already registered at Publons, they will notify you of the receipt of this review
and update your profile 
as per your settings and their policy. If you are not
registered with Publons, you will receive an email from them asking you to
register in order for them to be able to recognize your review on your new
profile page. Publons may use the Review Data to generate derivative metadata
for the benefit of Publons and you as a reviewer, carefully considering the
sensitivity of such information. For example, Publons may verify your record as
a reviewer by updating your profile published on its webservice if you have
registered for such service or help editors to identify candidate reviewers. Please
find the details of processing in Publons’ privacy policy
https://publons.com/about/terms
Yes
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.
Reviewer Publication Consent.
 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
) if this manuscript is accepted for
publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not
be published.
If you are not happy for us to publish this report, please contact the
editorial office before completing the review.
If you wish, you can include your
name in your published report. Please note you must decide whether to include
your name at the start of the process and confirm this decision whenever
prompted. If you change your decision later, we will not be able to publish your
name.
I agree to the terms of the CC-BY 4.0 license; please publish my name with my
report.
Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
No
Is the use of statistics and treatment of uncertainties appropriate?
No
Is the presentation of the work clear?
No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes
assistant