{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:15:13Z","timestamp":1792800913135,"version":"4.5.0"},"reference-count":17,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,19]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Immune checkpoint inhibitors (ICIs) are increasingly incorporated into perioperative cancer treatment, raising challenges in distinguishing immune-related adverse events (irAEs) from postoperative complications. We report a case of postoperative immune-related colitis following head and neck reconstructive surgery in a patient receiving long-term nivolumab. A man receiving nivolumab for gastric cancer, who was maintained on prednisolone for prior immune-related myositis, underwent subtotal glossectomy for advanced tongue cancer. Despite perioperative steroid coverage, he developed grade 3 diarrhoea on postoperative day 4. After infectious causes were excluded and CT revealed diffuse colitis, empirical corticosteroid therapy was initiated, with rapid symptom resolution; colonoscopy and biopsy supported a diagnosis of immune-related colitis. This case illustrates that irAE colitis should remain in the differential diagnosis of postoperative diarrhoea in patients with prior ICI exposure. As perioperative use of ICIs expands, clinicians should maintain a high index of suspicion for irAEs in patients presenting with postoperative diarrhoea.<\/jats:p>","DOI":"10.1136\/bcr-2026-274848","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:05:20Z","timestamp":1791302720000},"page":"e274848","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Immune-related colitis following head and neck reconstructive surgery in a patient receiving long-term nivolumab"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5448-368X","authenticated-orcid":false,"given":"Tatsuya","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohtaro","family":"Eguchi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiko","family":"Katoh","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Omura","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chihiro","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6418-921X","authenticated-orcid":false,"given":"Toshihiro","family":"Haga","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratories, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisuke","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Pathology and Clinical Laboratories, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Shoji","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidekazu","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Medical Oncology, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichi","family":"Yoshimoto","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, National Cancer Center Japan, Chuo, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026100609051562000_19.10.e274848.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200690"},{"key":"2026100609051562000_19.10.e274848.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30126-7"},{"key":"2026100609051562000_19.10.e274848.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1003466"},{"key":"2026100609051562000_19.10.e274848.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.04.008"},{"key":"2026100609051562000_19.10.e274848.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602252"},{"key":"2026100609051562000_19.10.e274848.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1703481"},{"key":"2026100609051562000_19.10.e274848.7","doi-asserted-by":"publisher","DOI":"10.1111\/his.13118"},{"key":"2026100609051562000_19.10.e274848.8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01440"},{"key":"2026100609051562000_19.10.e274848.9","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6385"},{"key":"2026100609051562000_19.10.e274848.10","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/CMR.0000000000000252","article-title":"Anti-PD1-induced collagenous colitis in a melanoma patient","volume":"26","author":"Baroudjian","year":"2016","journal-title":"Melanoma Res"},{"key":"2026100609051562000_19.10.e274848.11","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-316948"},{"key":"2026100609051562000_19.10.e274848.12","doi-asserted-by":"crossref","first-page":"174","DOI":"10.14694\/EdBook_AM.2012.32.79","article-title":"Practical management of immune-related adverse events from immune checkpoint protein antibodies for the oncologist","volume":"2012","author":"Weber","year":"2012","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"2026100609051562000_19.10.e274848.13","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1159\/000532004","article-title":"Remitting Seronegative Symmetrical Synovitis with Pitting Edema: A Case Report of an Immune-Related Adverse Event following Surgery","volume":"16","author":"Janse van Rensburg","year":"2023","journal-title":"Case Rep Oncol"},{"key":"2026100609051562000_19.10.e274848.14","doi-asserted-by":"crossref","first-page":"3682","DOI":"10.21037\/tlcr-21-603","article-title":"Consecutive severe immune-related adverse events after PD-1 inhibitor induction and surgery in locally advanced non-small cell lung cancer: a case report","volume":"10","author":"Zhao","year":"2021","journal-title":"Transl Lung Cancer Res"},{"key":"2026100609051562000_19.10.e274848.15","doi-asserted-by":"crossref","DOI":"10.1186\/s40792-021-01346-w","article-title":"Hypothyroidism and hypopituitarism as immune-related adverse events due to lenvatinib plus pembrolizumab therapy in the immediate postoperative period after laparoscopic hepatectomy for liver metastases from gastric cancer: a case report","volume":"7","author":"Sasaki","year":"2021","journal-title":"Surg Case Rep"},{"key":"2026100609051562000_19.10.e274848.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0306995","article-title":"Pre-existing autoimmune disease as a risk factor for immune-related adverse events in cancer patients receiving immune checkpoint inhibitors","volume":"19","author":"Sumimoto","year":"2024","journal-title":"PLoS One"},{"key":"2026100609051562000_19.10.e274848.17","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-21-1283"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-274848","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:05:22Z","timestamp":1791302722000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-274848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":17,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,6]]},"published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1136\/bcr-2026-274848"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-274848","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]}}}