Review for 10.1186/s12876-021-01994-0 (2021)

Reviewer’s report
Title: 
An isolated superior mesenteric artery dissection induced by childbirth
Version: 
0 
Date: 
05 Mar 2021
Reviewer's report:
The authors provide an interesting case of splanchnic artery dissection. The case
and paper are presented clearly and well written. Discussion is informative, but
may be a bit more neutral, especially regarding antithrombotic use. My minor
comments:
1/ Case section: 
- Can you provide more details about smoking habits and about the delivery ?
(Duration, difficulty, forceps, strenuous, any hypertension peak during delivery ?
- No recurrence occurred : please specifiy the duration of follow-up in the case
presentation, not only at the end of the manuscript.
2/ Discussion: 
- CT angiography should be preferred, not only because of clinicians preference,
but also to rule out small bowel ischemia and/or infarction. 
- Mesenteric ischemia is the most feared complication to expect and to monitor
while managing such a patient. Please discuss how clinicians may monitor
ischemia. Describe briefly the modern management of mesenteric ischemia
including antithrombotics, antibiotics, revascularization (PMID 29776790). In
our center, we reserve vascular interventional treatment to cases complicated
with AMI. In this case, digestive surgery may be required following published
risk factors (PMID 28266590).
- Please cite recents studies from Mayo Clinic showing recurrence rates as high
as 20% (PMID 31761101). THis suggests that current management may be
suboptimal and that antithrombotic may be critical for some patients. Recurrence
always carry a life-threatening risk of mesenteric ischemia.
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