Reviewer's report
Title:Perforated acute appendicitis resulting from appendiceal villous adenoma
presenting with small bowel obstruction: a case report
Version: 1Date:1 February 2011
Reviewer: Aravind Suppiah
Reviewer's report:
Minor issues not for publication
Abstract paragraph 1 - References should not be placed in abstract
Background - Paragraph 1 - Sequence of referencing is wrong. Please pay
attention to numerical sequence
Case presentation:
Second paragraph - please place references 6 and 7 at end of sentence, not
middle of sentence
Hours, not hours’
Minute - full text to be used the first occasion before abbreviating
Figures - please mark on images the level of obstruction
Minor essential revisions
1. Case presentation
Please clarify how the appendix came to lie on left side ? tethered
2. Fifth paragraph - please elaborate or give exact numbers or % of benign
appendiceal tumours from your references 6 and 7
3. Fifth paragraph - How rare is villous adenoma? Please give a % or
approximate number of reported cases in the literature.
4. Paragraph 7 - please explain what you mean by atypical symptoms - the
patient presented with typical symptoms of SBO
5. Paragraph 8. Last sentence - surely it is common sense to perform right
hemicolectomy if carcinoma was diagnosed pre-operatively or during surgery.
6. How would carcinoma be diagnosed preoperatively in this patients with SBO?
Is CT sufficiently sensitive to detect appendiceal adenocarcinoma?
7. Paragraph 8/9 - you should discuss the role of colonoscopy in surveillance in
greater depth i.e how frequent should it be performed and up to what age?
8. Conclusion
The last 2 sentences do not make sense. Please re-write
9. If this is so rare, why would you recommend routine frozen section?
Discretionary revision
10. The paragraphs in all sections are inconsistent in length. Please re-format
11. Discussion - the first 3 paragraphs should be shortened to one paragraph as
this does not add any educational value. Concentrate on the literature
surrounding your case
Summary
1. Much of the discussion in this case report has revolved around commonly
known facts.
2. There is little added in terms of further scientific interest. The true prevalence
e.g % or adenomas etc, have been avoided by using generic terms such as
“small proportions” or “quite rare” rather than providing a number.
3. The discussion about the potentially difficult issues in this case, e.g. what
proportions of adenomas, recommendation for colonoscopic follow-up, surgical
approach etc, have been avoided.
4. The conclusion is unsound
a. 3rd sentence is obvious i.e look for hernias - nothing to do with this case
b. 4th sentence - please re-write. Following up a specimen?
c. 5th - if so rare, how can the authors conclude the need for regularly arranged
frozen sections
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Needs some language corrections before being
published
Declaration of competing interests:
No competing interest
Reviewer's report
Title:Perforated acute appendicitis resulting from appendiceal villous adenoma
presenting with small bowel obstruction: a case report
Version: 1Date:1 February 2011
Reviewer: Aravind Suppiah
Reviewer's report:
Minor issues not for publication
Abstract paragraph 1 - References should not be placed in abstract
Background - Paragraph 1 - Sequence of referencing is wrong. Please pay
attention to numerical sequence
Case presentation:
Second paragraph - please place references 6 and 7 at end of sentence, not
middle of sentence
Hours, not hours’
Minute - full text to be used the first occasion before abbreviating
Figures - please mark on images the level of obstruction
Minor essential revisions
1. Case presentation
Please clarify how the appendix came to lie on left side ? tethered
2. Fifth paragraph - please elaborate or give exact numbers or % of benign
appendiceal tumours from your references 6 and 7
3. Fifth paragraph - How rare is villous adenoma? Please give a % or
approximate number of reported cases in the literature.
4. Paragraph 7 - please explain what you mean by atypical symptoms - the
patient presented with typical symptoms of SBO
5. Paragraph 8. Last sentence - surely it is common sense to perform right
hemicolectomy if carcinoma was diagnosed pre-operatively or during surgery.
6. How would carcinoma be diagnosed preoperatively in this patients with SBO?
Is CT sufficiently sensitive to detect appendiceal adenocarcinoma?
7. Paragraph 8/9 - you should discuss the role of colonoscopy in surveillance in
greater depth i.e how frequent should it be performed and up to what age?
8. Conclusion
The last 2 sentences do not make sense. Please re-write
9. If this is so rare, why would you recommend routine frozen section?
Discretionary revision
10. The paragraphs in all sections are inconsistent in length. Please re-format
11. Discussion - the first 3 paragraphs should be shortened to one paragraph as
this does not add any educational value. Concentrate on the literature
surrounding your case
Summary
1. Much of the discussion in this case report has revolved around commonly
known facts.
2. There is little added in terms of further scientific interest. The true prevalence
e.g % or adenomas etc, have been avoided by using generic terms such as
“small proportions” or “quite rare” rather than providing a number.
3. The discussion about the potentially difficult issues in this case, e.g. what
proportions of adenomas, recommendation for colonoscopic follow-up, surgical
approach etc, have been avoided.
4. The conclusion is unsound
a. 3rd sentence is obvious i.e look for hernias - nothing to do with this case
b. 4th sentence - please re-write. Following up a specimen?
c. 5th - if so rare, how can the authors conclude the need for regularly arranged
frozen sections
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Needs some language corrections before being
published
Declaration of competing interests:
No competing interest
Please review this paper.
user
Reviewer's report
Title:Perforated acute appendicitis resulting from appendiceal villous adenoma
presenting with small bowel obstruction: a case report
Version: 1Date:1 February 2011
Reviewer: Aravind Suppiah
Reviewer's report:
Minor issues not for publication
Abstract paragraph 1 - References should not be placed in abstract
Background - Paragraph 1 - Sequence of referencing is wrong. Please pay
attention to numerical sequence
Case presentation:
Second paragraph - please place references 6 and 7 at end of sentence, not
middle of sentence
Hours, not hours’
Minute - full text to be used the first occasion before abbreviating
Figures - please mark on images the level of obstruction
Minor essential revisions
1. Case presentation
Please clarify how the appendix came to lie on left side ? tethered
2. Fifth paragraph - please elaborate or give exact numbers or % of benign
appendiceal tumours from your references 6 and 7
3. Fifth paragraph - How rare is villous adenoma? Please give a % or
approximate number of reported cases in the literature.
4. Paragraph 7 - please explain what you mean by atypical symptoms - the
patient presented with typical symptoms of SBO
5. Paragraph 8. Last sentence - surely it is common sense to perform right
hemicolectomy if carcinoma was diagnosed pre-operatively or during surgery.
6. How would carcinoma be diagnosed preoperatively in this patients with SBO?
Is CT sufficiently sensitive to detect appendiceal adenocarcinoma?
7. Paragraph 8/9 - you should discuss the role of colonoscopy in surveillance in
greater depth i.e how frequent should it be performed and up to what age?
8. Conclusion
The last 2 sentences do not make sense. Please re-write
9. If this is so rare, why would you recommend routine frozen section?
Discretionary revision
10. The paragraphs in all sections are inconsistent in length. Please re-format
11. Discussion - the first 3 paragraphs should be shortened to one paragraph as
this does not add any educational value. Concentrate on the literature
surrounding your case
Summary
1. Much of the discussion in this case report has revolved around commonly
known facts.
2. There is little added in terms of further scientific interest. The true prevalence
e.g % or adenomas etc, have been avoided by using generic terms such as
“small proportions” or “quite rare” rather than providing a number.
3. The discussion about the potentially difficult issues in this case, e.g. what
proportions of adenomas, recommendation for colonoscopic follow-up, surgical
approach etc, have been avoided.
4. The conclusion is unsound
a. 3rd sentence is obvious i.e look for hernias - nothing to do with this case
b. 4th sentence - please re-write. Following up a specimen?
c. 5th - if so rare, how can the authors conclude the need for regularly arranged
frozen sections
Level of interest: An article of insufficient interest to warrant publication in a
scientific/medical journal
Quality of written English: Needs some language corrections before being
published
Declaration of competing interests:
No competing interest
assistant