Reviewer’ s report
Title: Retrospective study of the differential diagnosis between cryptogenic multifocal ulcerous
stenosing enteritis and small bowel Crohn’ s disease
Version: 0Date: 11 Mar 2020
Reviewer: Jan Bureš
Reviewer's report:
Dan Chen et al. submitted a study on the differential diagnosis of CMUSE and Crohn's disease. It
is an interesting paper, however, there are several major drawbacks.Major comments:*There is no information on medical therapy in the past history of patients. Some patients mightuse NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs-induced small intestinal injury cancause multiple ulcers and stenoses and similar symptoms as CMUSE and Crohn's disease. Theauthors did not mention the use of NSAIDs either in patient description or discussion. Thus,several concerns raised how appropriate and true was the diagnosis of CMUSE and Crohn'sdisease.*Duodenal involvement, intestinal fistulas and positivity of ASCA were recorded in few patientswith CMUSE. However, such a finding excludes CMUSE definitely.*Fourteen patients were evaluated in a retrospective study in the period 1984 - 2017. It is not clearhow double-balloon enteroscopy could be performed in 12/14 patients (only two patients werediagnosed between 1984 and 2004?). Double balloon enteroscopy has been introduced in clinicalpractice since early 2000's.*"Haematochezia" means "presence of blood in the faeces". It is not clear if it was overt or occult
bleeding. Information how the bleeding was diagnosed is missing. No information on
haemoglobin values was provided.*Nutritional status was not investigated.*Ten patients with CMUSE were operated on, however, no histology findings are provided.*Type 2 error beta was not calculated for low but not significant p values.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre 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 furtherassessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration 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 thismanuscript, 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.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 reportincluding 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 included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
Reviewer’ s report
Title: Retrospective study of the differential diagnosis between cryptogenic multifocal ulcerous
stenosing enteritis and small bowel Crohn’ s disease
Version: 0Date: 11 Mar 2020
Reviewer: Jan Bureš
Reviewer's report:
Dan Chen et al. submitted a study on the differential diagnosis of CMUSE and Crohn's disease. It
is an interesting paper, however, there are several major drawbacks.Major comments:*There is no information on medical therapy in the past history of patients. Some patients mightuse NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs-induced small intestinal injury cancause multiple ulcers and stenoses and similar symptoms as CMUSE and Crohn's disease. Theauthors did not mention the use of NSAIDs either in patient description or discussion. Thus,several concerns raised how appropriate and true was the diagnosis of CMUSE and Crohn'sdisease.*Duodenal involvement, intestinal fistulas and positivity of ASCA were recorded in few patientswith CMUSE. However, such a finding excludes CMUSE definitely.*Fourteen patients were evaluated in a retrospective study in the period 1984 - 2017. It is not clearhow double-balloon enteroscopy could be performed in 12/14 patients (only two patients werediagnosed between 1984 and 2004?). Double balloon enteroscopy has been introduced in clinicalpractice since early 2000's.*"Haematochezia" means "presence of blood in the faeces". It is not clear if it was overt or occult
bleeding. Information how the bleeding was diagnosed is missing. No information on
haemoglobin values was provided.*Nutritional status was not investigated.*Ten patients with CMUSE were operated on, however, no histology findings are provided.*Type 2 error beta was not calculated for low but not significant p values.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre 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 furtherassessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration 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 thismanuscript, 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.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 reportincluding 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 included in my named report can be included as confidential commentsto 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: Retrospective study of the differential diagnosis between cryptogenic multifocal ulcerous
stenosing enteritis and small bowel Crohn’ s disease
Version: 0Date: 11 Mar 2020
Reviewer: Jan Bureš
Reviewer's report:
Dan Chen et al. submitted a study on the differential diagnosis of CMUSE and Crohn's disease. It
is an interesting paper, however, there are several major drawbacks.Major comments:*There is no information on medical therapy in the past history of patients. Some patients mightuse NSAIDs (non-steroidal anti-inflammatory drugs). NSAIDs-induced small intestinal injury cancause multiple ulcers and stenoses and similar symptoms as CMUSE and Crohn's disease. Theauthors did not mention the use of NSAIDs either in patient description or discussion. Thus,several concerns raised how appropriate and true was the diagnosis of CMUSE and Crohn'sdisease.*Duodenal involvement, intestinal fistulas and positivity of ASCA were recorded in few patientswith CMUSE. However, such a finding excludes CMUSE definitely.*Fourteen patients were evaluated in a retrospective study in the period 1984 - 2017. It is not clearhow double-balloon enteroscopy could be performed in 12/14 patients (only two patients werediagnosed between 1984 and 2004?). Double balloon enteroscopy has been introduced in clinicalpractice since early 2000's.*"Haematochezia" means "presence of blood in the faeces". It is not clear if it was overt or occult
bleeding. Information how the bleeding was diagnosed is missing. No information on
haemoglobin values was provided.*Nutritional status was not investigated.*Ten patients with CMUSE were operated on, however, no histology findings are provided.*Type 2 error beta was not calculated for low but not significant p values.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
NoDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
NoAre 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 furtherassessment in your comments to the editors.
I am able to assess the statistics
Quality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration 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 thismanuscript, 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.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 reportincluding 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 included in my named report can be included as confidential commentsto the editors, which will not be published.
I agree to the open peer review policy of the journal
assistant