Reviewer ’s report  
 
Title:  A case of ectopic pancreas in the ileum presenting as obscure gastrointestinal bleeding and 
abdominal pain  
 
Version: 1 Date: 09 Dec 2018 
 
Reviewer:  Aswini Kumar  Pujahari  
 
Reviewer’s report:  
 
Abstract - 
 
1"(also referred to as heterotopic pancreas, pancreatic heterotopia, accessory pancreas, aberrant 
pancreas, or pancreatic rest)" is repeated both in abstract and  the main text. The same can be 
omitted from the abstract to make the crisp and abstract like.  
 
2.Line 20 "low hemoglobin level, i.e. 109 g/L (10.9 g/dL)" one cane be omitted. Just 10.9 G/dL 
will suffice.  
 
3. line 23   "Large" must be followed by its size, i t could have been measured and written the 
size with the marking at least in one image.  
 
4. Line 27 "involving muscular layer" . Which muscle layer, muscularis mucosae, circular  or 
longitudinal needs to be mentioned and same to be marked on histological im age. When the post 
polypectomy image is   not in consonance with the description.  
 
5 page 27 -28- Only one arrow in the image two picture low and high power microscopic view.  
 
The muscle layer in a pedunculated polyp whereis nor marked on histology  
 
6.Conclusi on. Same as last conclusion - abstract conclusion can be short.  
 
Our case report reveals very rare cause of obscure gastrointestinal bleeding accompanied with 
episodes of abdominal pain - an ectopic pancreas located in ileum. Although ileal polyp was 
located  by magnetic resonance enterography and later by retrograde enteroscopy, diagnosis of 
ectopic pancreas could not be made until polypectomy and histopathological examination  
  
7.Key wards - Perfect  
 
Main Text - 
 
8 line 17 -- Suggested "recurrent"   to obscured GI bleed to be added.  
 
9. Line 37 - He had pain at left upper abdominal pain but the lesion is located at right lower part 
on MR study. The authors have no explained the diagonally opposite finding. Needs expla nation.  
A mention no lump was palpable will be appropriate.  
 
10 Line 40 Haemoglobin in L or dL as mentioned point two. How ever  I do not have any serious 
objection  
 
11. The polyp size is changing in size. MRI, Enteroscopy and biopsy specimen.  So MR 
measur ed size will be better and other part of the text only polyp is suggested.  
 
12. Page -4 --20 CC adrenalin saline injected. Looks a large volume for small bowel. The image 
B is not showing the same. Please reconcile.  
 
13. Images are the brain and heart of case  reports.  Enteroscopic view are the real images in this 
case.. The author should have given few more images. At least one more view showing the 
pedicle with the endo -loop have been most appropriate.  
 
Discussion - It is written well. Two aspect needed high l ight. One the location of ectopic 
pancreatic tissue in terms of which layer of the small bowel. And the second is the ectopic  
pancreas tissue and bleeding.  
 
References - 
 
They are not uniform.  
 
Ref 3 - is shown as the link. But actually it should have been lik e given as below - 
 
"3. Edward C.S.Lai. FRCSE, FRACSa2. Ronald K.Tompkins MD, Heterotopic pancreas: 
Review of a 26 year experience The American Journal of Surgery 1986,6:697 -700,1986, 697 -
700 doi.org/10.1016/0002 -9610(86)90045 -0" 
 
No.13 - in Chinese print.  
 
If the journal policy allows that, I do not have any objection.  
  
Images - The comments are already incorporated  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the  work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following q uestions:  
 
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.  
 
No, I declare that I have no competing interests  
 
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 website 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 includ ed in my named 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:  A case of ectopic pancreas in the ileum presenting as obscure gastrointestinal bleeding and 
abdominal pain  
 
Version: 1 Date: 09 Dec 2018 
 
Reviewer:  Aswini Kumar  Pujahari  
 
Reviewer’s report:  
 
Abstract - 
 
1"(also referred to as heterotopic pancreas, pancreatic heterotopia, accessory pancreas, aberrant 
pancreas, or pancreatic rest)" is repeated both in abstract and  the main text. The same can be 
omitted from the abstract to make the crisp and abstract like.  
 
2.Line 20 "low hemoglobin level, i.e. 109 g/L (10.9 g/dL)" one cane be omitted. Just 10.9 G/dL 
will suffice.  
 
3. line 23   "Large" must be followed by its size, i t could have been measured and written the 
size with the marking at least in one image.  
 
4. Line 27 "involving muscular layer" . Which muscle layer, muscularis mucosae, circular  or 
longitudinal needs to be mentioned and same to be marked on histological im age. When the post 
polypectomy image is   not in consonance with the description.  
 
5 page 27 -28- Only one arrow in the image two picture low and high power microscopic view.  
 
The muscle layer in a pedunculated polyp whereis nor marked on histology  
 
6.Conclusi on. Same as last conclusion - abstract conclusion can be short.  
 
Our case report reveals very rare cause of obscure gastrointestinal bleeding accompanied with 
episodes of abdominal pain - an ectopic pancreas located in ileum. Although ileal polyp was 
located  by magnetic resonance enterography and later by retrograde enteroscopy, diagnosis of 
ectopic pancreas could not be made until polypectomy and histopathological examination  
  
7.Key wards - Perfect  
 
Main Text - 
 
8 line 17 -- Suggested "recurrent"   to obscured GI bleed to be added.  
 
9. Line 37 - He had pain at left upper abdominal pain but the lesion is located at right lower part 
on MR study. The authors have no explained the diagonally opposite finding. Needs expla nation.  
A mention no lump was palpable will be appropriate.  
 
10 Line 40 Haemoglobin in L or dL as mentioned point two. How ever  I do not have any serious 
objection  
 
11. The polyp size is changing in size. MRI, Enteroscopy and biopsy specimen.  So MR 
measur ed size will be better and other part of the text only polyp is suggested.  
 
12. Page -4 --20 CC adrenalin saline injected. Looks a large volume for small bowel. The image 
B is not showing the same. Please reconcile.  
 
13. Images are the brain and heart of case  reports.  Enteroscopic view are the real images in this 
case.. The author should have given few more images. At least one more view showing the 
pedicle with the endo -loop have been most appropriate.  
 
Discussion - It is written well. Two aspect needed high l ight. One the location of ectopic 
pancreatic tissue in terms of which layer of the small bowel. And the second is the ectopic  
pancreas tissue and bleeding.  
 
References - 
 
They are not uniform.  
 
Ref 3 - is shown as the link. But actually it should have been lik e given as below - 
 
"3. Edward C.S.Lai. FRCSE, FRACSa2. Ronald K.Tompkins MD, Heterotopic pancreas: 
Review of a 26 year experience The American Journal of Surgery 1986,6:697 -700,1986, 697 -
700 doi.org/10.1016/0002 -9610(86)90045 -0" 
 
No.13 - in Chinese print.  
 
If the journal policy allows that, I do not have any objection.  
  
Images - The comments are already incorporated  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the  work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following q uestions:  
 
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.  
 
No, I declare that I have no competing interests  
 
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 website 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 includ ed in my named 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:  A case of ectopic pancreas in the ileum presenting as obscure gastrointestinal bleeding and 
abdominal pain  
 
Version: 1 Date: 09 Dec 2018 
 
Reviewer:  Aswini Kumar  Pujahari  
 
Reviewer’s report:  
 
Abstract - 
 
1"(also referred to as heterotopic pancreas, pancreatic heterotopia, accessory pancreas, aberrant 
pancreas, or pancreatic rest)" is repeated both in abstract and  the main text. The same can be 
omitted from the abstract to make the crisp and abstract like.  
 
2.Line 20 "low hemoglobin level, i.e. 109 g/L (10.9 g/dL)" one cane be omitted. Just 10.9 G/dL 
will suffice.  
 
3. line 23   "Large" must be followed by its size, i t could have been measured and written the 
size with the marking at least in one image.  
 
4. Line 27 "involving muscular layer" . Which muscle layer, muscularis mucosae, circular  or 
longitudinal needs to be mentioned and same to be marked on histological im age. When the post 
polypectomy image is   not in consonance with the description.  
 
5 page 27 -28- Only one arrow in the image two picture low and high power microscopic view.  
 
The muscle layer in a pedunculated polyp whereis nor marked on histology  
 
6.Conclusi on. Same as last conclusion - abstract conclusion can be short.  
 
Our case report reveals very rare cause of obscure gastrointestinal bleeding accompanied with 
episodes of abdominal pain - an ectopic pancreas located in ileum. Although ileal polyp was 
located  by magnetic resonance enterography and later by retrograde enteroscopy, diagnosis of 
ectopic pancreas could not be made until polypectomy and histopathological examination  
  
7.Key wards - Perfect  
 
Main Text - 
 
8 line 17 -- Suggested "recurrent"   to obscured GI bleed to be added.  
 
9. Line 37 - He had pain at left upper abdominal pain but the lesion is located at right lower part 
on MR study. The authors have no explained the diagonally opposite finding. Needs expla nation.  
A mention no lump was palpable will be appropriate.  
 
10 Line 40 Haemoglobin in L or dL as mentioned point two. How ever  I do not have any serious 
objection  
 
11. The polyp size is changing in size. MRI, Enteroscopy and biopsy specimen.  So MR 
measur ed size will be better and other part of the text only polyp is suggested.  
 
12. Page -4 --20 CC adrenalin saline injected. Looks a large volume for small bowel. The image 
B is not showing the same. Please reconcile.  
 
13. Images are the brain and heart of case  reports.  Enteroscopic view are the real images in this 
case.. The author should have given few more images. At least one more view showing the 
pedicle with the endo -loop have been most appropriate.  
 
Discussion - It is written well. Two aspect needed high l ight. One the location of ectopic 
pancreatic tissue in terms of which layer of the small bowel. And the second is the ectopic  
pancreas tissue and bleeding.  
 
References - 
 
They are not uniform.  
 
Ref 3 - is shown as the link. But actually it should have been lik e given as below - 
 
"3. Edward C.S.Lai. FRCSE, FRACSa2. Ronald K.Tompkins MD, Heterotopic pancreas: 
Review of a 26 year experience The American Journal of Surgery 1986,6:697 -700,1986, 697 -
700 doi.org/10.1016/0002 -9610(86)90045 -0" 
 
No.13 - in Chinese print.  
 
If the journal policy allows that, I do not have any objection.  
  
Images - The comments are already incorporated  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the  work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following q uestions:  
 
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.  
 
No, I declare that I have no competing interests  
 
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 website 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 includ ed in my named 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