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6 yo patient with recently received a BMT and has a rash of face and trunk.

GVHD

SX: diarrhea, cramping, fever, n/v
“ribbon bowel”-SB fold effacement with tubular appearance, loss of haustra, spasm, edema, ulceration, granular mucosa in colon
”SB cast”-prolonged coating of abnormal bowel for hours to days
Fatal in up to 15% due to opportunistic infix.
TX: steroids, cyclosporine
DDX: super infection with enterovirus
DDX Terminal lleal Disease

• IBD- Crohn (stenosis), UC (gaping valve, backwash ileitis)
• Tumor-Carcinoma, Lymphoma, Carcinoid
• Infection- TB, Yersinia, Salmonella, CMV
• Inflammatory-extension from cecum/appendix

DDx Coned Cecum

• IBD
• Tumor- carcinoma, met
• Infection- TB, CMV, Actinomyces, Blasto, Typhoid, Yersinia, Amebiasis
• Inflammation-appendicitis, typhlitis, diverticulitis