Review for 10.1186/s12876-021-01752-2 (2021)

Reviewer’s report
Title: 
Left-Side Incarcerated Amyand’s Hernia with Appendix and Caecum
provoke by Early Banana Diet: A Case Report
Version: 
1 
Date: 
11 Mar 2021
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? 
Yes, this report contributes to medical knowledge
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?
No - there are minor issues
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: What is your overall impression of the report? 
Note I was not the original reviewer therefore I will review this as a new
submission This submission needs quite a bit of editing for grammar and word
usage BUT it does have a potential tidally important message that an early
banana diet, especially in young children with an inguinal hernia can lead to
bowel incarceration . Also Amyand's hernia usually refers to just the appendix
being trapped in the hernia sac not the cecum as well 
I think this is a minor point
but should be acknowledged
Are you confident in the authors' description and interpretation of the report? 
The description is appropriate but the terminology of a true Amyand's hernia that
differentiates it from a more classic incarcerated inguinal hernia is that it usually
refers to just the appendix being incarcerated in the hernia sac and not the distal
small bowel and cecum. The title though is not accurate the patient did not have
appendicitis at least when I look at the appendix it appears normal
Have the authors clearly outlined the need for publication by novelty of the case
or the specific adverse event? 
Yes I think there is a definite message here for mothers in Indonesia. And for this
reason justifies strong consideration of publication especially is the manuscript
also describes how to educate the population of the importance of not using a
banana diet in neonates !
REQUESTED REVISIONS: 
Suggested changes 
1.please in the future number the pages OR number the lines in a progressive
way-not just a new set of 
numbers for each page ( unless you also number the
pages- this will make it much easier for the reviewer and the editor to address
suggestions to 
individual parts of the manuscript.
2 abstract line 6 
the incidence of 4 to 6% is far too high. Do you mean for
incarcerated hernias! 
Also you can say that this occurs primarily on the right side
in the first sentence and thereby delete the 5th sentence of the abstract. Also
most people think of Amyand's hernia as containing only the appendix
3. 4th sentence of abstract if there is small bowel obstruction( also note small
intestinal obstruction is usually referred to as "small bowel obstruction" and is
abbreviated SBO 
and not SIO) 
then abdominal distention 
can occur please
reword it also 
4. Abstract lines 30 and 31. What is a "cito 
herniotomy procedure"? 
Being a left
sided Amyand's hernia did the patient have situs inversus or 
was there an
extremely mobile cecum?
5. Abstract line 40 I would strongly suggest that this be reworded as " This case
suggests the possibility of early feeding of a banana diet may provoke
incarceration of an inguinal hernia and if the incarcerated hernia contents
contains the appendix, then an Amyand's hernia". 
5 Background page line 8 change in to "into" and reword the next sentence to
"Rarely, the appendix can be found in the inguinal sac of an inguinal hernia
which has been called an Amyand's hernia.
6. Background 
Again line 15. 4 to 6 % is far too high especially with the 1%
described in line 20 this needs to be changed to a more realistic %. 
7. Background line 25 and discussion line 52 change " followed by" to
"associated with" 
and change the word "diver" on line 30 to " differentiate" 
8. Background line 37 change "intestinal obstruction (IBO) " to "small bowel
obstruction( SBI)" this is the more common terminology in the literature
9. Background lines 47 and 50 do you mean "was" or "is"? 
That is, is the banana
diet still common today?
10. Case presentation line 6 and 8 change the word "repositioned" to " reduced"
also line 8 change the word " for" to " from"
11. Case presentation line 33 what do your mean by "excoriated " when
describing the cecum. The figure to me looks like an erythematous cecum not
excoriated; excoriation 
means external trauma with bleeding g from the serosal
surface
12. Case presentation line 38-40. You say " hernia repair" what do you mean by
this. Do you mean just ligation of the sac or did you really try to obliterate the
internal hernia defect ( internal ring- 
that would be quite unusual in a neonate!
13. Discussion line 15 change " could perform 
following" to " can 
develop in an
incarcerated" 
14 discussion lines 23-32. Please define all the types of Amyland's hernia so the
reader understands all the types
15. Discussion lines 35-47 did your patient have situs Inversus ? He obviously
had a mobile cecum you should describe or at the least say it. 
16 discussion is the early banana diet still common in Indonesia today? 
If so this
needs to be stressed and some statement made to highlight the risk of this
especially if the paper by Wiryo and colleagues really did show that the
incidence of SBO was as high as 9%; was this really good epidemiologic study?.
Also more solid foods do not stay as solid food in the small intestine e so the
ability of neonate to "digest" banana implies that there is a large amount of
nondigestable fiber in banana. This needs to be explained.
17. Your title needs to be changed. Your patient did not have appendicitis so
delete the term appendicitis in the title
18 on the conclusions-please make more effort to describe how to educate the
mothers to prevent this complication. Also change the term "morbidity " to "
intestinal obstruction". the term 
morbidity 
is too general.
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