Review for 10.1186/s12876-020-01312-0 (2020)

Reviewer ’s report  
 
Title: Hemorrhagic cholecystitis with rare imaging presentation: a case report and a lesson 
learned  from neglected medication history of NSAIDs  
 
Version: 0 Date: 26 Dec 2019  
 
Reviewer: Jun Sakata  
 
Reviewer's report:  
 
The authors reported a case of a patient with hemorrhagic cholecystitis. They were unable to rule 
out the possibility of gallbl adder cancer preoperatively. They advocate that the cause of 
hemorrhagic cholecystitis was a long -term oral use of NSAIDs. They concluded that this case 
suggests the importance of preoperative review of medication history and patient education on 
prescript ion drug abuse.  
In general, this is a well -written paper that presents an interesting case. However, I have the 
following major concerns.  
 
#1 Although we know that a long -term use of NSAIDs increase the risk of gastrointestinal 
bleeding or perforation, how  many reports, which show that NSAIDs is a cause of hemorrhagic 
cholecystitis, are there in the literature? How many cases reported? The authors should 
investigate the incidence of NSAIDs -associated hemorrhagic cholecystitis and discuss about the 
mechanism  of its occurrence.  
 
#2 In the Background section, the authors stated that gallstone -associated cholecystitis is an 
"established" risk factor of gallbladder cancer. I think that the controversy exists regarding this 
issue. So, this sentence should be modif ied. 
 
#3 I think that it is better to discuss about the hemorrhagic cholecystitis due to the malignancy 
because the authors could not rule out the diagnosis of gallbladder cancer.  
 
#4 Figure 4 should be deleted.  
 
 
 
 
 
 
 
 
 
 
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to t he authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
No 
 
Are 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 further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
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1. Have you in the past five years received reimbursements, fees, funding, o r salary from an  
organisation that may in any way gain or lose financially from the publication of this  
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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?  
 
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below.  If your reply is yes to any, please give details below.  
 
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