Reviewer's report
Title:Hypoglycemia Following Upper Gastrointestinal Surgery: Case Report and
Review of the Literature
Version: 2Date:23 September 2009
Reviewer: Mary Korytkowski
Reviewer's report:
Brandon et al present a case report of a patient who experienced hypoglycemia
following a fundoplication procedure for repair of a hiatal hernia.
This is a brief report.
The abstract does not add anything as it is actually the case summary.
The novelty of this case is that symptoms occurred following a surgical procedure
that is not usually associated with hypoglycemia. The fact that his symptoms
were present pre-operatively suggests that this may not have been related to the
surgery. A discussion of the mechanisms by which this type of surgery could
worsen symptoms would be useful. Mechanisms following RNYGBP procedures
have been discussed previously but may not be relevant to fundoplication.
Although the CT scan was negative, a small insulinoma is not completely ruled
out and could be considered in the differential. Hypoglcyemia is not limited to the
fasting state in patients with insulinoma, and a negative 72 hour fast does not
absoutely eliminate this possiblity.
I would recommend that the abstract and case summary be combined and
condensed, that there be a discussion of proposed mechanisms as well as a
discussion of how Octreotide works and any prior studies using octreotide in
these patients.
The severity of the hypoglycemic event is also of interest. A blood glucose of 0.8
mmol/l without loss of consciousness is unusual.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Hypoglycemia Following Upper Gastrointestinal Surgery: Case Report and
Review of the Literature
Version: 2Date:23 September 2009
Reviewer: Mary Korytkowski
Reviewer's report:
Brandon et al present a case report of a patient who experienced hypoglycemia
following a fundoplication procedure for repair of a hiatal hernia.
This is a brief report.
The abstract does not add anything as it is actually the case summary.
The novelty of this case is that symptoms occurred following a surgical procedure
that is not usually associated with hypoglycemia. The fact that his symptoms
were present pre-operatively suggests that this may not have been related to the
surgery. A discussion of the mechanisms by which this type of surgery could
worsen symptoms would be useful. Mechanisms following RNYGBP procedures
have been discussed previously but may not be relevant to fundoplication.
Although the CT scan was negative, a small insulinoma is not completely ruled
out and could be considered in the differential. Hypoglcyemia is not limited to the
fasting state in patients with insulinoma, and a negative 72 hour fast does not
absoutely eliminate this possiblity.
I would recommend that the abstract and case summary be combined and
condensed, that there be a discussion of proposed mechanisms as well as a
discussion of how Octreotide works and any prior studies using octreotide in
these patients.
The severity of the hypoglycemic event is also of interest. A blood glucose of 0.8
mmol/l without loss of consciousness is unusual.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Hypoglycemia Following Upper Gastrointestinal Surgery: Case Report and
Review of the Literature
Version: 2Date:23 September 2009
Reviewer: Mary Korytkowski
Reviewer's report:
Brandon et al present a case report of a patient who experienced hypoglycemia
following a fundoplication procedure for repair of a hiatal hernia.
This is a brief report.
The abstract does not add anything as it is actually the case summary.
The novelty of this case is that symptoms occurred following a surgical procedure
that is not usually associated with hypoglycemia. The fact that his symptoms
were present pre-operatively suggests that this may not have been related to the
surgery. A discussion of the mechanisms by which this type of surgery could
worsen symptoms would be useful. Mechanisms following RNYGBP procedures
have been discussed previously but may not be relevant to fundoplication.
Although the CT scan was negative, a small insulinoma is not completely ruled
out and could be considered in the differential. Hypoglcyemia is not limited to the
fasting state in patients with insulinoma, and a negative 72 hour fast does not
absoutely eliminate this possiblity.
I would recommend that the abstract and case summary be combined and
condensed, that there be a discussion of proposed mechanisms as well as a
discussion of how Octreotide works and any prior studies using octreotide in
these patients.
The severity of the hypoglycemic event is also of interest. A blood glucose of 0.8
mmol/l without loss of consciousness is unusual.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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