Review for 10.1186/s12876-022-02253-6 (2022)

Reviewer’s report
Title: 
Emphysematous cystitis as a potential marker of severe Crohn's disease: a
case report
Version: 
1 
Date: 
07 Mar 2022
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
RELEVANCE - Does this case report make a contribution to medical
knowledge, have educational value, or highlight the need for a change in clinical
practice or diagnostic/prognostic approaches? 
No, the findings of this report are well known and/or similar reports have already
been published
CASE DESCRIPTION - Are the details of the case sufficiently well described to
understand the patient's symptoms and course of treatment? 
Yes, the description of the case is sufficient
DIAGNOSIS/INTERPRETATION - Based on the facts presented, are the
diagnosis, interpretation, and course of treatment medically sound?
Yes, the work described is medically sound
DISCUSSION OF THE CASE - Does the discussion appropriately analyse the
importance of the findings and their relevance to future understanding of disease
processes, diagnosis or treatment? Has an adequate literature review pertinent to
the case been included?
Yes, the case is discussed fully in the context of the literature
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED
version of this work represent a technically sound contribution?
Probably - with minor revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: The case report provides a solid description that is
interpreted well. In and of itself, the case is interesting, but there are some
questions about its clinical utility. The presence of emphysematous cystitis in a
Crohn's patient without a fistula is interesting, but by the authors' own admission,
it has never been reported before and isn't clear that it's a marker of severe
disease as a result. Also, the story around the goiter seems unresolved.
REQUESTED REVISIONS: 
The difficulty in evaluating the work is that they are trying to showcase EC as a
potential sign of severe Crohn's, while simultaneously saying it has never been
documented in non-fistulizing disease before. These two ideas aren't mutually
compatible. If the manuscript was rewritten to emphasize that it's a potential
unappreciated sign, or a new sign worthy of investigating, then it would be a
more coherent case.
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