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Answer: Acute graft versus host disease.

Findings: There is diffuse enhancement and wall thickening involving the colon and small bowel. Given the distribution and appearance of the findings, along with the clinical history of bone marrow transplant, graft versus host disease is the most likely etiology.

Infectious processes would also be included in the differential diagnosis.

Upper GI endoscopy with biopsy and skin biopsy were performed. Pathology was compatible with acute graft versus host disease.

Diffuse wall thickening and enhancement in the colon:

Diffuse wall thickening and enhancement in the small bowel:

How would you treat this condition?

  • Surgery
  • Antibiotics
  • Corticosteroids, with cyclosporine or tacrolimus.
  • Supportive therapy only
  • Radiation Therapy
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