Reviewer's report
Title:Case series of Meckel's diverticulum: usefulness of double-balloon
enteroscopy for diagnosis
Version:2Date:12 May 2014
Reviewer: Martin Keuchel
Reviewer's report:
The authors present a very interesting case series on patients with Meckel´s
diverticulum diagnosed by double balloon enteroscopy.
Although this series neither allows a reliable epidemiologic analysis nor a valid
comparison between methods due to selection bias and uncontrolled application
of the different tests it presents several remarkable aspects:
Symptoms arising from Meckel´s diverticulum are not restricted to childhood (the
oldest patient was 83 years, mean age 31.5 years). Nevertheless, also in this
older group of patients, painless GI bleeding was the leading symptom.
Data, although not systematic, suggest that retrograde (double) balloon
enteroscopy is the best diagnostic test for Meckel´s diverticulum. However, an
inverted diverticulum may lead to misinterpretation. The possibility to diagnose
Meckel´s diverticulum during antegrade double balloon enteroscopy via selective
enterography although the lesion cannot be reached directly with the endoscope
is an interesting approach.
CT scan seems to do better in detection than in correct diagnosis. Even in the
presence of ectopic gastric mucosa, Meckel scan was negative in one case.
Information would be of interest about possible use of proton pump inhibitor in
this patient that might have contributed to false negative scan.
(Meckel´s) diverticula missed by capsule endoscopy have been reported before.
The round capsule endoscopic image rather suggests use of a Pillcam SB1 than
SB2 as described in the text.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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:Case series of Meckel's diverticulum: usefulness of double-balloon
enteroscopy for diagnosis
Version:2Date:12 May 2014
Reviewer: Martin Keuchel
Reviewer's report:
The authors present a very interesting case series on patients with Meckel´s
diverticulum diagnosed by double balloon enteroscopy.
Although this series neither allows a reliable epidemiologic analysis nor a valid
comparison between methods due to selection bias and uncontrolled application
of the different tests it presents several remarkable aspects:
Symptoms arising from Meckel´s diverticulum are not restricted to childhood (the
oldest patient was 83 years, mean age 31.5 years). Nevertheless, also in this
older group of patients, painless GI bleeding was the leading symptom.
Data, although not systematic, suggest that retrograde (double) balloon
enteroscopy is the best diagnostic test for Meckel´s diverticulum. However, an
inverted diverticulum may lead to misinterpretation. The possibility to diagnose
Meckel´s diverticulum during antegrade double balloon enteroscopy via selective
enterography although the lesion cannot be reached directly with the endoscope
is an interesting approach.
CT scan seems to do better in detection than in correct diagnosis. Even in the
presence of ectopic gastric mucosa, Meckel scan was negative in one case.
Information would be of interest about possible use of proton pump inhibitor in
this patient that might have contributed to false negative scan.
(Meckel´s) diverticula missed by capsule endoscopy have been reported before.
The round capsule endoscopic image rather suggests use of a Pillcam SB1 than
SB2 as described in the text.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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:Case series of Meckel's diverticulum: usefulness of double-balloon
enteroscopy for diagnosis
Version:2Date:12 May 2014
Reviewer: Martin Keuchel
Reviewer's report:
The authors present a very interesting case series on patients with Meckel´s
diverticulum diagnosed by double balloon enteroscopy.
Although this series neither allows a reliable epidemiologic analysis nor a valid
comparison between methods due to selection bias and uncontrolled application
of the different tests it presents several remarkable aspects:
Symptoms arising from Meckel´s diverticulum are not restricted to childhood (the
oldest patient was 83 years, mean age 31.5 years). Nevertheless, also in this
older group of patients, painless GI bleeding was the leading symptom.
Data, although not systematic, suggest that retrograde (double) balloon
enteroscopy is the best diagnostic test for Meckel´s diverticulum. However, an
inverted diverticulum may lead to misinterpretation. The possibility to diagnose
Meckel´s diverticulum during antegrade double balloon enteroscopy via selective
enterography although the lesion cannot be reached directly with the endoscope
is an interesting approach.
CT scan seems to do better in detection than in correct diagnosis. Even in the
presence of ectopic gastric mucosa, Meckel scan was negative in one case.
Information would be of interest about possible use of proton pump inhibitor in
this patient that might have contributed to false negative scan.
(Meckel´s) diverticula missed by capsule endoscopy have been reported before.
The round capsule endoscopic image rather suggests use of a Pillcam SB1 than
SB2 as described in the text.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
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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