Anterior and Posterior Nutcracker Syndrome Combined with May–Thurner Syndrome: First Report of This Unique Case
, Federica Galioto 2, Giulio Distefano 3,*, Stefano Palmucci 1, Antonio Basile 1 and Salvatore Di Rosa 4Round 1
Reviewer 1 Report
line 21 her instead of their
line 25 dilation instead of dilatation
line 25 and varicose pelvic veins
line 25 Axial CT imaging
line 26 showed instead of shows
line 28 a combination instead of the combination
line 50 "The presence of a circumaortic venous ring with a simultaneous compression..."
line 50 between the abdominal aorta and the SMA
line 51 in the literature
line 60 complained of pain in her mid-back....
line 64 hepatic instead of liver
line 65 hepatic MRI
line 65 thoracic and lumbar spine
line 66 skeletal scintigraphy
line 67 inferior vena cava
line 72 varicose pelvic veins
line 73 demonstrated
line 74 demonstrated
line 76 axial CT imaging showed compression.... in the venous phase.
line 79 axial CT image showing a marked narrowing...
line 80 axial CT image showing...
line 82 MIP showing...
line 86 showing
line 91 showing
line 92 dilation
line 100-101 "varies from 2 to 17% in post-mortem studies. It can also be seen as an incidental finding on 1-3% of abdominal CT scans"
line 103 "the simultaneous compression of the.... is referred to as combined nutcracker syndrome"
line 105 We searched the MEDLINE, Embase and Google Scholar databases for literature....
line 106 ..."and found only four previously published reports on this condition"
line 108 "first case of combined nutcracker syndrome in adolescent age - a 16-year-old patient with flank pain"
line 112 Table 1. Summary of the previously published cases of combined anterior and posterior nutcracker syndrome
line 118 left-sided flank pain
line 122 anatomy of the LRV and its relationship....
line 126 "MDCT allows the assessment..."
line 127 typically ranging from...
line 131 there are no defined angle criteria for posterior NS
line 141 for NCS if over 3mmHg
line 142 depending on the symptom severity
line 156 allowing for visualization
line 160 There are three previously published reports in the literature...
line 163 We report a case of concomitant.... not previously described in the literature.
line 168 incidentally intead of casually
line 171-172 delete (too colloquial and informal)
line 180 this is not a retrospective analysis, but a case report. Was consent obtained from the patient (if alive) or the patient's next of kin to collect, describe and publish her medical data?
Author Response
We have modified the manuscript as you suggested
Reviewer 2 Report
Your case describes a unique pathology and therefore it would be necessary to include more information regarding your patient's past and present medical history: heredo-collateral antecedents, other associated pathologies, present and past lab tests, chronic therapy, if any. Furthermore, you should include some data related to the treatment management, once you established the diagnosis, and the prognosis of your patient. In addition, the paragraph between lines 105-111 (including Table 1) describes in fact the methodology of your work and should be deleted from the Discussion - please insert the Methodology section according to the Journal instructions. For a better understanding of this case, more data regarding nutcracker syndrome should be included: history, epidemiology, diagnosis and treatment possibilities and overall outcome. Please also explain the acronyms used in Table 1 (below the table as a note).
Author Response
- “Your case describes a unique pathology and therefore it would be necessary to include more information regarding your patient's past and present medical history: heredo-collateral antecedents, other associated pathologies, present and past lab tests, chronic therapy, if any”.
We include other information regarding your patient's past and present medical history;
- “Furthermore, you should include some data related to the treatment management, once you established the diagnosis, and the prognosis of your patient”.
Due to the patient’s oncological disease, she didn’t start treatment management.
- “In addition, the paragraph between lines 105-111 (including Table 1) describes in fact the methodology of your work and should be deleted from the Discussion - please insert the Methodology section according to the Journal instructions”.
We described the methodology of our work, including a new paragraph “Literature Review”, that included materials and method, and results
- “For a better understanding of this case, more data regarding nutcracker syndrome should be included: history, epidemiology, diagnosis and treatment possibilities and overall outcome”.
We included more data regarding nutcraker syndrome.
- “Please also explain the acronyms used in Table 1 (below the table as a note)”.
We explained the acronyms LRV (= left renal vein) below the table as a note
Round 2
Reviewer 2 Report
You performed all the recommended modifications and consequently your article has been improved.
