S evere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus responsible for coronavirus disease 2019 (COVID-19). 1,2 The virus enters cells via the angiotensin-converting enzyme 2 receptor, which is present in enterocytes in the ileum and colon. 3 Gastrointestinal (GI) manifestations include diarrhea, nausea, vomiting, and abdominal pain, and the prevalence of GI symptoms varies greatly, with a range between 2% and 57%. 4 In addition, abnormal liver chemistries are reported commonly. 4 As a medical center at the forefront of the early epidemic in the United States, we seek to contribute to the growing body of literature that outlines the gastrointestinal and hepatic manifestations of COVID-19. Methods We performed a retrospective review of consecutive adult nonpregnant patients admitted to New York-Presbyterian Queens Hospital in Flushing, NY, for SARS-CoV-2 between March 14, 2020, and April 1, 2020 (Supplementary Methods). The Fisher exact, chi-square, and Wilcoxon rank-sum tests were used to compare groups, and a P value less than .05 was considered statistically significant. This study was approved by the New York-Presbyterian Queens Institutional Review Board.

Duodenal perforation due to biliary stent migration is rare, and it often requires surgical repair; however, endoscopic closure has recently become a viable option in the appropriate patients. We present the case of a 79-year-old female who underwent biliary stent placement for a common bile duct stricture, who subsequently was found to have a duodenal wall perforation secondary to stent migration. The stent was extracted endoscopically with successful defect closure using a ConMed® repositional DuraClip™. We aim to contribute to the limited body of literature that describes endoscopic repair of duodenal perforation secondary to biliary stent migration using through-the-scope endoclips.

Pulmonary squamous cell carcinoma is the second most common non–small cell malignancy of the lung. It commonly metastasizes to the adrenal glands, bone, liver, brain, and kidneys. Most occurrences of metastatic squamous cell carcinoma involving the gastrointestinal tract originate from primary lung tumors. Metastasis to the duodenum, however, is exceedingly rare, with very few cases of stomach or duodenal involvement described in the literature. We report the case of a patient with stage IV pulmonary squamous cell carcinoma metastasizing to the duodenum with an uncommon presentation to add to the paucity of literature available regarding this rare finding.

A 77-year-old man was treated at our institution over a 2-year period for multiple aneurysms associated with diffuse aneurysmal disease. Consent was obtained to describe his vascular therapy. He initially presented in 2013 for a ruptured abdominal aortic aneurysm that was repaired with an aortouniiliac device and right-to-left femoral-femoral bypass; a left internal iliac artery aneurysm and the left external iliac artery were coil embolized at that time. Persistent bilateral groin lymphoceles and a complex home life delayed further intervention until July, 2015, at which point he underwent endovascular repair of a distal left superficial femoral and popliteal artery aneurysm. A three-dimensional computed tomography reconstruction obtained after this surgery (A/Cover).He subsequently underwent extension of his initial aortouniiliac device into the external iliac artery and coil embolization of an enlarging right hypogastric aneurysm.Aneurysmosis is a condition in which individuals develop diffuse aneurysms in the setting of arteriomegaly or long-segment dilatation of arteries, a term first used by Dr Lea Thomas in 1971. 1 Although a significant body of literature has described the propensity for peripheral aneurysms to develop concurrently with abdominal aortic aneurysms, aneurysmosis has not been studied extensively. This condition is thought to result from the confluence of genetic and acquired risk factors that lead to the degeneration of the arterial wall or owing to several systemic inflammatory conditions that predispose to vessel dilatation. A multidisciplinary approach is required to treat this condition; concurrent aneurysms of the central, peripheral, and cerebral vasculature have been described. 2 The image is provided courtesy of M2S, Inc. REFERENCES 1. Thomas ML. Arteriomegaly. Br J Surg 1971;58:690-4. 2. Moazzam AA, Savvas SN, Amar AP, Ham SW, Panush RS, Clavijo LC. Diffuse aneurysmal disease -a review. Rev Vasc Med 2014;2:48-57.