Background Emerging evidence suggests that severe form of coronavirus disease 2019 (COVID-19) is mediated, in part, by a hypercoagulable state characterized by micro- and macro-vascular thrombotic angiopathy. Although venous thrombotic events in COVID-19 patients have been well described, data on arterial thrombosis (AT) in these patients is still limited. We, therefore, conducted a rapid systematic review of current scientific literature to identify and consolidate evidence of AT in COVID-19 patients. Methods A systematic search of literature was conducted between November 1, 2019, and June 9, 2020, on PubMed and China National Knowledge Infrastructure to identify potentially eligible studies. Results A total of 27 studies (5 cohort, 5 case series, and 17 case reports) describing arterial thrombotic events in 90 COVID-19 patients were included. The pooled incidence of AT in severe/critically ill intensive care unit–admitted COVID-19 patients across the 5 cohort studies was 4.4% (95% confidence interval 2.8–6.4). Most of the patients were male, elderly, and had comorbidities. AT was symptomatic in >95% of these patients and involved multiple arteries in approximately 18% of patients. The anatomical distribution of arterial thrombotic events was wide, occurring in limb arteries (39%), cerebral arteries (24%), great vessels (aorta, common iliac, common carotid, and brachiocephalic trunk; 19%), coronary arteries (9%), and superior mesenteric artery (8%). The mortality rate in these patients is approximately 20%. Conclusions AT occurs in approximately 4% of critically ill COVID-19 patients. It often presents symptomatically and can affect multiple arteries. Further investigation of the underlying mechanism of AT in COVID-19 would be needed to clarify possible therapeutic targets.

Coronavirus disease 2019 (COVID-19) is a rapidly escalating pandemic that has spread to many parts of the world. Current data available on COVID-19 would suggest that SARS-CoV-2 virus is shed through the gastrointestinal system via feces. Some reports further indicate that a subset of COVID-19 patients may continue to have positive SARS-CoV-2 anal/rectal swab and stool test after negative conversion of nasopharyngeal test. This paper analyses current literature to so as to shed some light on this issue.

Splenic flexure cancers (SFCs) account for up to 8% of all colon cancers (CCs) [1,2]. Although relatively uncommon, the prognosis for SFC is generally poor, with patients often presenting with colonic obstruction, advanced tumour stages and distant metastasis [1-3]. Surgical resection of CC has traditionally been undertaken viaan open approach [1]. Laparoscopic resection, however, has gained popularity, with randomized clinical trials demonstrating superior short-term outcomes (lower pain scores, reduced blood loss and shorter convalescence) and similar long-term oncological outcomes to open surgery [4][5][6]. Laparoscopic resection of SFC is technically demanding due to the steep learning curve associated with the procedure and the complex regional anatomy characterized by the presence of embryological adhesions, proximity to important organs such as the spleen and pancreas, and a highly heterogeneous

Rouvière's sulcus (RS) is increasingly being recognized as an important extra‐biliary landmark during laparoscopic cholecystectomy (LC). The aim of this study was to conduct a systematic analysis of the prevalence and morphological types of RS. A systematic search was conducted through the major databases PubMed, ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), SciELO, and the Cochrane Library to identify studies eligible for inclusion. The data were extracted and pooled into a random‐effects meta‐analysis using STATA software. The primary and secondary outcomes of the study were the pooled prevalence of RS and its morphological types, respectively. A total of 23 studies (n = 4,495 patients) were included. The overall pooled prevalence of RS was 83% (95% confidence interval [CI] [78, 87]). There were no significant differences in prevalence between cadaveric studies (82%, 95% CI [76, 87]) and laparoscopic studies (83%, 95% CI [77, 88]). The open RS constituted 66% (95% CI [61, 71]) of all cases, while the closed type was present in 34% (95% CI [29, 39]). RS is a relatively constant anatomical structure that can be reliably identified in most patients undergoing cholecystectomy. It can therefore be used as a fixed extra‐biliary landmark for the appropriate site at which to start dissecting during LC to help prevent iatrogenic bile duct injury.

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