Background and purpose The frequency, risk factors as well as the sites of biliary stent migration are variable in the literature. This retrospective study investigated the frequency of biliary stent migration, why biliary stents migrated, how the migrated stents affected the patients, and what are the different techniques retrieved the migrated stents. Patients and methods Out of 876 stented patients, 74 patients (8.4%) had their stents migrated. Patients with and without migrated stents were compared regarding endoscopy and stent-related parameters. The sequels of stent migrations were reported. Furthermore, the methods used for stent retrieval were reviewed. Results Proximal and distal stent migration occurred at a rate of 3 and 5.5%, respectively. The independent predictors for stent migration were moderate to marked common bile duct (CBD) dilation, complete sphincterotomy, the use of balloon dilation, and stent insertion for more than 1 month. Cholangitis and stent obstruction was the most commonly reported adverse event (n = 18, 24.3%). Distal stent migration associated with two cases of bleeding due to duodenal wall injury, and two cases of duodenal perforation. All the retained migrated stents in the current study were retrieved by endoscopy using extraction balloon, Dormia basket, snares, and foreign body forceps. Conclusion Biliary stent migration occurs at a rate of 8.4%. Stents do migrate because of dilated CBD, wide sphincterotomy, and biliary balloon dilation. Furthermore, wide, straight stents inserted for more than 1 month easily migrate. The migrated stents migrated intraluminal in the CBD, duodenum or the colon. All the retained migrated stents were retrieved endoscopically.

No abstract

Background: Coronavirus disease-2019 (COVID-19) is a global pandemic health problem which causes a wide spectrum of clinical manifestations and considerable mortality rates. Unfortunately, recovered patients who survive COVID-19 may continue to report wide varieties of clinical manifestations of multisystem affection such as fatigue, dyspnea, myalgia, anxiety, depression, acute myocardial infarction, peripheral and pulmonary embolisms. Objective: We aimed to assess the prevalence of post-COVID-19 manifestations. Methods: We conducted a systematic review on post COVID-19 manifestations by searching Pubmed, Scopus, Web of Science (WOS), EBSCO, Wily, and World health organization (WHO) databases. Screening, selection, data extraction, data synthesis and quality assessment were done by two independent reviewers. Results: Of 1,371 references, 817 references remained after duplicates, reviews; case reports, commentaries, and any article containing non-original information were removed. According to eligibility criteria for this systematic review, 12 studies were included for qualitative synthesis. The overall prevalence of post-COVID-19 manifestations ranged from 35% to 90.5%. Fatigue, dyspnea, neuropsychological disorders, and pain were the most frequent post COVID-19 symptoms. Conclusion: This systematic review showed that 35% to 90.5% of recovered patients who survive COVID-19 continue to have wide varieties of clinical manifestations and fatigue, dyspnea, neuropsychological disorders, and pain were the most frequent post COVID-19 symptoms.

Background Since the emergence of the novel corona virus (SARS-Cov-2) in the late 2019 and not only the endoscopy practice and training but also the health care systems around the globe suffers. This systematic review focused the impact of Corona Virus Disease (COVID-19) on the endoscopy practice. Methods A web search of different databases combining different search terms describing the endoscopy practice and the COVID-19 pandemic was done. Articles were screened for selection of relevant articles in two steps: title and abstract step and full-text screening step, by two independent reviewers and any debate was solved by a third reviewer. Results Final studies included in qualitative synthesis were 47. The data shown in the relevant articles were evident for marked reduction in the volume of endoscopy, marked affection of colorectal cancer screening, impairments in the workflow, deficiency in personal protective equipment (PPE) and increased likelihood of catching the infection among both the staff and the patients. Conclusion The main outcomes from this review are rescheduling of endoscopy procedures to be suitable with the situation of COVID-19 pandemic in each Country. Also, the endorsement of the importance of PPE use for health care workers and screening of COVID-19 infection pre-procedure. Key messages The data focussing Gastrointestinal Endoscopy and COVID-19 emerged from different areas around the globe. The data presented on the published studies were heterogeneous. However, there were remarkable reductions in the volume of GI endoscopy worldwide Staff reallocation added a burden to endoscopy practice There was a real risk for COVID-19 spread among both the staff and the patients

We present three diabetic patients cases presented with kentonuria as the presenting manifestation of SARS-CoV-2 infection.