Gastric ulcers with upper gastrointestinal bleeding in patients with severe SARS-CoV-2.

A new coronavirus, SARS-CoV-2, was identified earlier this year and spread rapidly globally. The clinical manifestations that it produces have gradually become known and the typical clinical picture is respiratory. Although gastrointestinal symptoms have been described in several communications, information on endoscopic findings in these patients is practically zero. We describe two cases of upper gastrointestinal bleeding in patients with COVID-19. In both cases, the presence of gastric ulcers was identified in an unusual location, the gastric fundus. After ruling out malignancy, our suspicion was an ischemic etiology that is consistent with terminal gastric vascularization at the gastric fundus level and increased thrombotic phenomena in patients with COVID-19.

[New techniques to extract impacted partially covered metallic biliary stents]. / Nuevas técnicas para extraer prótesis biliares metálicas recubiertas impactadas.

One of the problems affecting metallic biliary stents is the difficulty of removing them, especially after a period of months or if they have migrated. Several approaches have been used to remove both covered and uncovered stents, although with different degrees of effectiveness. We report two new approaches to removing partially covered stents that migrated proximally and that impacted in the papillary area and distal common bile duct. One stent was removed by papillectomy and the other by using duodenoscopy-guided controlled radial expansion balloon dilation. In both cases, the stents were removed without severe complications for the patient, leaving a good caliber in the stenosis.