Reviewer’s report
Title: 
Transvaginal strangulated bowel evisceration through uterine perforation due to unsafe abortion: A
case report and literature review
Version: 
0 
Date: 
05 Sep 2020
Reviewer's report:
General comments:
1. With only two patients, I am not sure that this presentation will impress many readers as a 'Case series'.
2. The authors really need to ask themselves: what is unique or outstanding in the presentation and
management of these women, that has not been reported before in the literature? That will be the selling
point of this report.
3. There were a good number of grammatical and syntax anomalies in the narrative, which suggests that
this manuscript was not read critically by an English language speaker who has a reasonable knowledge of
medical writing.
4. I notice that after one of the patients had a hemi-colectomy, no nasogastric tube was passed around the
time of surgery. Is this the normal practice?
5. It is remarkable that, despite the authors mentioning that the laws of Cameroon on abortion, there was
no further remark about (a) whether the law enforcement agents were involved at any stage of the patients'
care or after (b) if the medical community in Cameroon has done anything to address matters of this
nature, which will become a recurring problem otherwise.
Specific comments:
Line 47-78: In the section on Introduction, the authors make mention of terms such as abortion, elective
abortion, clandestine abortion and induced unsafe abortion. I suggest a sequence to this, and to please
focus on the cases to be presented.
Line 80-81: There is the phrase: 'lack of women's autonomy with respect to abortion laws in Cameroon'.
What does this really mean?
Line 81: 'a rape' (remove 'a').
Line 88: 'case below' ( suggest : cases below).
Line 91-92: 
'..this case has been postponed'. What does this mean?
Line 92: 
Suggest 'CARE guidelines'.
Line 99/100: 
Change to: 'four days before', and 'when she was 10 weeks pregnant'.
Line 100: change 'an' to 'a'.
Line 161-163: No need to mention the Postmenopausal woman here. Discuss these two patients.
Line 165-169: No need to mention 'uterine rupture' here. We tend to use such a term in advanced
pregnancy, and usually when there has been a prior uterine scar. Please just relate your discussion to the
two patients you managed.
Line 181: Suggest adjust 'viscera' to 'viscus' in the context used.
Line 187: Suggest adjust 'lawful' to either 'reasonable' or 'logical'.
Line 221: I am not sure that it is safe to cauterize the any area of traumatized bowel.
Line 222: What does 'simple raffia' mean? You mean: simple repair?
Line 229: What does the term 'Pronostic' mean?
Line 229-234: Please see comments on the segment Line Lines 165-169.
Line 235-242: Everything mentioned in this paragraph amounts to proper training and skills update of
healthcare personnel who provide this service. Since the legal position of the Republic of Cameroon is not
favourable to induced abortion, the problem will not simply go away.
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