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Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

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Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
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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...
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Inflammatory Bowel Disease II: Ulcerative Colitis01:20

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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...
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Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Inflammatory Bowel Disease II: Crohn's Disease01:30

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Crohn's disease
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Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

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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...
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Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

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Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
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Murine Ileocolic Bowel Resection with Primary Anastomosis
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Ipilimumab-induced colonic perforation.

Lyle Burdine1, Keith Lai2, Jonathan A Laryea3

  • 1Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA ljburdine@uams.edu.

Journal of Surgical Case Reports
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This summary is machine-generated.

Ipilimumab, a biologic immune modulator for metastatic melanoma, can cause severe colitis. This case highlights a rare but serious gastrointestinal side effect requiring surgical intervention and prolonged recovery.

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Area of Science:

  • Oncology
  • Immunology
  • Gastroenterology

Background:

  • Metastatic melanoma treatment often involves biologic immune modulators.
  • Ipilimumab is a key immunotherapy agent targeting cytotoxic T-lymphocyte-associated protein 4 (CTLA-4).
  • Immune-related adverse events (irAEs) are known complications of ipilimumab therapy.

Observation:

  • A 52-year-old male with metastatic melanoma developed colitis after ipilimumab initiation.
  • Initial treatment with drug cessation and steroids failed, leading to colonic perforation.
  • The patient underwent hemicolectomy and experienced prolonged enteritis post-surgery.

Findings:

  • Severe colitis, a rare immune-related adverse event, complicated ipilimumab treatment.
  • Despite aggressive management, the patient required surgical intervention for colonic perforation.
  • Resolution of autoimmune colitis occurred after several weeks, allowing patient discharge.

Implications:

  • This case underscores the potential for severe gastrointestinal toxicity with ipilimumab.
  • Early recognition and management of irAEs are critical in ipilimumab therapy.
  • Understanding ipilimumab's side effect profile is crucial for adjuvant therapy in melanoma.