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Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

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Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
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Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy

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Ipilimumab-associated colitis: CT findings.

Kyung Won Kim1, Nikhil H Ramaiya, Katherine M Krajewski

  • 1Department of Imaging, Brigham and Women's Hospital, MA 02115, USA. medimash@gmail.com

AJR. American Journal of Roentgenology
|May 31, 2013
PubMed
Summary

Computed tomography (CT) imaging reveals two distinct patterns of ipilimumab-associated colitis: diffuse colitis and segmental colitis associated with diverticulosis (SCAD). These patterns differ in CT findings, clinical presentation, and treatment strategies for patients receiving ipilimumab immunotherapy.

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Area of Science:

  • Radiology
  • Oncology
  • Gastroenterology

Background:

  • Ipilimumab is an immune checkpoint inhibitor used in cancer therapy.
  • Immune-related adverse events, including colitis, can occur with ipilimumab treatment.
  • Accurate CT imaging is crucial for diagnosing and characterizing ipilimumab-associated colitis.

Purpose of the Study:

  • To describe the computed tomography (CT) findings associated with ipilimumab-induced colitis.
  • To identify distinct radiologic patterns of ipilimumab-associated colitis.
  • To correlate CT findings with clinical features and treatment outcomes.

Main Methods:

  • Retrospective review of 16 patients with ipilimumab-associated colitis and available CT scans.
  • Consensus review of CT images by two radiologists for specific findings (bowel wall thickening, enhancement, distention, pneumatosis, fat stranding, mesenteric engorgement).
  • Review of medical records for clinical features, management, and outcomes.

Main Results:

  • Common CT findings included mesenteric vessel engorgement (81.3%) and bowel wall thickening (75%).
  • Two distinct patterns were identified: diffuse colitis (n=12) and segmental colitis associated with diverticulosis (SCAD) (n=4).
  • Diffuse colitis presented with watery diarrhea and steroid treatment; SCAD presented with mixed diarrhea, cramping, and treatment with steroids and antibiotics.

Conclusions:

  • Ipilimumab-associated colitis exhibits two main CT patterns: diffuse and SCAD.
  • These patterns are associated with different clinical presentations and require distinct management approaches.
  • CT imaging plays a vital role in differentiating these patterns for optimal patient care.