ArticleCureus2025
Ileostomy for Refractory Immune Checkpoint Inhibitor-Associated Colitis: A Case Report and Literature Review.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
Immune checkpoint inhibitors (ICIs) are widely used to treat malignant tumors and have transformed cancer treatment; however, immune-related adverse events (irAEs) can occur due to excessive immune responses. Among these, immune checkpoint inhibitor-related colitis (irAE colitis) presents with symptoms resembling ulcerative colitis, for which high-dose corticosteroids and anti-TNF-alpha antibodies are recommended. Surgical treatment has not been well established for cases refractory to medical therapy. We report a case of a 64-year-old male patient with PD-L1-positive recurrent lung adenocarcinoma who developed hematochezia and diarrhea eight weeks after initiating pembrolizumab, leading to a diagnosis of irAE colitis. Despite treatment with corticosteroids, infliximab, mesalazine, and leukocytapheresis, the colitis remained refractory. Due to the patient's poor performance status, proctocolectomy and subtotal colectomy were not indicated, and a diverting loop ileostomy was performed to rest the colon. Following surgery, abdominal symptoms resolved, allowing chemotherapy to resume three months later. Stoma closure was not possible due to persistent mucosal lesions on colonoscopy, but no symptoms of colitis were observed, and nivolumab was administered from the 18
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