Reviewer's report 
 Septic thrombophlebitis of the mesenteric vein and multiple liver abscesses in a patient with Crohn`s Title: 
disease at onset. 
 2  21 November 2006 Version: Date: 
 Gottfried Novacek Reviewer: 
Reviewer's report: 
General 
This is an interesting case report of liver abscesses and a serious thrombotic complication in a patient with CD, which was caused by bacterial infection due to the underlying CD. However, the case report has some 
weaknesses. Especially, a careful description of the operation including the surgical and the pathological 
report, which are supposed to deliver the most reliable results on the presence of fistula and fibrostenosis, 
is missed (evidence of fistula?). ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
The described palpable mass in the right lower abdominal quadrant is highly suspicious of an inflammatory mass not only resulting from stenosis and bowel wall thickening but also resulting from penetrating disease. The author should clearly describe in the Case Report which kind of operation was performed 5 months 
after the patient was dicharged and if they found any evidence of fistula in the bowel resection specimen 
either in the surgical or in the pathological report. 
Figure 2 was citated twice: Once in the description of the first abdominal CT scan leading to the diagnosis of 
liver abscesses and mesenteric thrombosis but also a second time when a control CT scan was performed 
prior to the operation (5 months later)! Does Figure 2 belong to the first or to the second CT scan? ------------------------------------------------------------------------------- Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
The title should be modified to: Septic thrombophlebitis of the superior mesenteric vein... 
Linguistic improvements should be performed, some of which are listed below: 
Proposal for the first part of the Case Report: A 25-year-old white male CD patient was admitted to our 
hospital due to fever and right lower quadrant abdominal pain. Six years previously he suffered from 
perianal fistulas and underwent perianal surgery including drainage and fistulectomy. Two years later CD of 
the terminal ileum was diagnosed. The patient was treated with mesalazine and was in clincal remission 
most of the time, except for occasinal episodes of mild watery diarrhoea without fever. 
Two months prior to admission the patient... 
What was the highest dose of prednisone? 
What were the body weight and the BMI? 
What was the diameter of the largest liver abscess? 
The authors state that an underlying hypercoagulable condition was ruled out. However, I could not find any 
data on factor V Leiden (or resistance to activated protein C), which is the most common inherited 
thrombophilic disorder known until now, and on prothrombin mutation. The authors should comment on this. 
Table 1: Are the values put in parentheses the normal values? This should be clearly defined in the legend. 
Figure 1 and 2: The findings should be shortly described and be marked by arrows. 
------------------------------------------------------------------------------- Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Not suitable for publication unless extensively edited Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests' below. 
Reviewer's report 
 Septic thrombophlebitis of the mesenteric vein and multiple liver abscesses in a patient with Crohn`s Title: 
disease at onset. 
 2  21 November 2006 Version: Date: 
 Gottfried Novacek Reviewer: 
Reviewer's report: 
General 
This is an interesting case report of liver abscesses and a serious thrombotic complication in a patient with CD, which was caused by bacterial infection due to the underlying CD. However, the case report has some 
weaknesses. Especially, a careful description of the operation including the surgical and the pathological 
report, which are supposed to deliver the most reliable results on the presence of fistula and fibrostenosis, 
is missed (evidence of fistula?). ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
The described palpable mass in the right lower abdominal quadrant is highly suspicious of an inflammatory mass not only resulting from stenosis and bowel wall thickening but also resulting from penetrating disease. The author should clearly describe in the Case Report which kind of operation was performed 5 months 
after the patient was dicharged and if they found any evidence of fistula in the bowel resection specimen 
either in the surgical or in the pathological report. 
Figure 2 was citated twice: Once in the description of the first abdominal CT scan leading to the diagnosis of 
liver abscesses and mesenteric thrombosis but also a second time when a control CT scan was performed 
prior to the operation (5 months later)! Does Figure 2 belong to the first or to the second CT scan? ------------------------------------------------------------------------------- Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
The title should be modified to: Septic thrombophlebitis of the superior mesenteric vein... 
Linguistic improvements should be performed, some of which are listed below: 
Proposal for the first part of the Case Report: A 25-year-old white male CD patient was admitted to our 
hospital due to fever and right lower quadrant abdominal pain. Six years previously he suffered from 
perianal fistulas and underwent perianal surgery including drainage and fistulectomy. Two years later CD of 
the terminal ileum was diagnosed. The patient was treated with mesalazine and was in clincal remission 
most of the time, except for occasinal episodes of mild watery diarrhoea without fever. 
Two months prior to admission the patient... 
What was the highest dose of prednisone? 
What were the body weight and the BMI? 
What was the diameter of the largest liver abscess? 
The authors state that an underlying hypercoagulable condition was ruled out. However, I could not find any 
data on factor V Leiden (or resistance to activated protein C), which is the most common inherited 
thrombophilic disorder known until now, and on prothrombin mutation. The authors should comment on this. 
Table 1: Are the values put in parentheses the normal values? This should be clearly defined in the legend. 
Figure 1 and 2: The findings should be shortly described and be marked by arrows. 
------------------------------------------------------------------------------- Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Not suitable for publication unless extensively edited Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests' below. 
Please review this paper.
user
Reviewer's report 
 Septic thrombophlebitis of the mesenteric vein and multiple liver abscesses in a patient with Crohn`s Title: 
disease at onset. 
 2  21 November 2006 Version: Date: 
 Gottfried Novacek Reviewer: 
Reviewer's report: 
General 
This is an interesting case report of liver abscesses and a serious thrombotic complication in a patient with CD, which was caused by bacterial infection due to the underlying CD. However, the case report has some 
weaknesses. Especially, a careful description of the operation including the surgical and the pathological 
report, which are supposed to deliver the most reliable results on the presence of fistula and fibrostenosis, 
is missed (evidence of fistula?). ------------------------------------------------------------------------------- Major Compulsory Revisions (that the author must respond to before a decision on publication can be 
reached) 
The described palpable mass in the right lower abdominal quadrant is highly suspicious of an inflammatory mass not only resulting from stenosis and bowel wall thickening but also resulting from penetrating disease. The author should clearly describe in the Case Report which kind of operation was performed 5 months 
after the patient was dicharged and if they found any evidence of fistula in the bowel resection specimen 
either in the surgical or in the pathological report. 
Figure 2 was citated twice: Once in the description of the first abdominal CT scan leading to the diagnosis of 
liver abscesses and mesenteric thrombosis but also a second time when a control CT scan was performed 
prior to the operation (5 months later)! Does Figure 2 belong to the first or to the second CT scan? ------------------------------------------------------------------------------- Minor Essential Revisions (such as missing labels on figures, or the wrong use of a term, which the author 
can be trusted to correct) 
The title should be modified to: Septic thrombophlebitis of the superior mesenteric vein... 
Linguistic improvements should be performed, some of which are listed below: 
Proposal for the first part of the Case Report: A 25-year-old white male CD patient was admitted to our 
hospital due to fever and right lower quadrant abdominal pain. Six years previously he suffered from 
perianal fistulas and underwent perianal surgery including drainage and fistulectomy. Two years later CD of 
the terminal ileum was diagnosed. The patient was treated with mesalazine and was in clincal remission 
most of the time, except for occasinal episodes of mild watery diarrhoea without fever. 
Two months prior to admission the patient... 
What was the highest dose of prednisone? 
What were the body weight and the BMI? 
What was the diameter of the largest liver abscess? 
The authors state that an underlying hypercoagulable condition was ruled out. However, I could not find any 
data on factor V Leiden (or resistance to activated protein C), which is the most common inherited 
thrombophilic disorder known until now, and on prothrombin mutation. The authors should comment on this. 
Table 1: Are the values put in parentheses the normal values? This should be clearly defined in the legend. 
Figure 1 and 2: The findings should be shortly described and be marked by arrows. 
------------------------------------------------------------------------------- Discretionary Revisions (which the author can choose to ignore) 
 Unable to decide on acceptance or rejection until the authors have responded to the major What next?: 
compulsory revisions 
 An article of importance in its field Level of interest: 
 Not suitable for publication unless extensively edited Quality of written English: 
 No Statistical review: 
Declaration of competing interests: 
I declare that I have no competing interests' below. 
assistant