Background : Surgical resection of Crohn’s disease is followed by early recurrence in a high percentage of patients. Mesalazine has been shown to be effective in the prevention of post‐operative recurrence, but some 50% of patients under treatment recur at 3 years of follow‐up. Aim : To establish whether the mucosal concentration of mesalazine might affect the development of post‐operative recurrence. Methods : Colon‐ileoscopy was performed in 25 consecutive patients resected for Crohn’s disease. The mean time from surgery was 14 months. After the operation, all patients were taking oral mesalazine (Asacol, 2.4 g/day). Ten patients showed signs of endoscopic recurrence (apthae, ulcers, narrowing of the lumen) in the neoterminal ileum, five of whom also showed juxta‐anastomotic colonic involvement. Fifteen patients were free of recurrence. At endoscopy, four biopsies were taken from the perianastomotic area (two specimens at the ileal site and two specimens at the colonic site of the anastomosis). The specimens were weighed and immediately frozen at −80 °C. Mesalazine concentration (ng/mg) was measured in tissue homogenates by high‐ performance liquid chromatography with electrochemical detection. Fisher’s exact test was used for the statistical analysis. Results : The mean value of mucosal mesalazine concentration, expressed as ng/mg of tissue, was significantly lower in patients with recurrence than in those without recurrence both in the ileum (mean ± s.d.: 21.6 ± 28.3 vs. 70.9 ± 47.4; P = 0.007) and in the colon (25.8 ± 26.4 vs. 60.3 ± 32.5; P = 0.010). Conclusions : The mucosal conentration of mesalazine in the juxta‐anastomatic area is significantly lower in patients with recurrence than in those free of recurrence. These data could suggest an association between mucosal mesalazine concentrations and the clinical effectiveness of the drug.

A 36-year-old man presented with a 6-month history of a painful 3×4 cm mass in the perineum. There was no associated history of trauma, erectile dysfunction, penile deformity or urinary symptoms, and he was not a cyclist. On examination a tender fixed mass was found in the region of the crus of the left corpora cavernosum. A diCerential diagnosis at this stage included rhabdomyosarcoma or other mesenchymal neoplastic growths, including an epitheloid sarcoma [1]. Ultrasonography confirmed a perineal mass with invasion into the crus of the left corpus cavernosum (Fig. 1). Subsequent CT was not helpful. A wedge biopsy of the mass revealed hyalinized fibrous tissue in which occasional blood vessels were cuCed by chronic inflammatory cells. There was extension of the fibrous tissue into the superficial erectile tissue consistent with Peyronie's disease. The patient was treated for 9 months with tamoxifen, with resolution of the pain and a reduction in the size of the mass, and with preservation of erectile function. penoscrotal junction. A urethrogram revealed a normalcalibre urethra but with an area of calcification on its dorsal surface. Urethroscopy revealed that this abnorComments mality was not within the urethral wall. At exploration via a midline penoscrotal incision, the corpus sponPeyronie's disease was described in 1743, yet its aetiology remains unknown. The plaque is located on the giosum was mobilized to provide access to a hard midline mass at the junction of the crura within the septum of dorsal surface of the penis in 66% of cases, laterally in 20%, ventrally in 6% and within the septum in 6% the tunica albuginea. The histology of this lesion revealed bone in a Peyronie's plaque (Fig. 2). Postoperatively, the [2,3]. The reported location of the plaque is fairly evenly distributed along the pendulous part of the penis, in erectile diBculties persisted, with a slight left deviation of the erect penis, although he could still obtain and several series [2-4]. Peyronie's disease has never been described in the crus of the penis. These two cases show maintain erections suBcient for penetration and therefore did not want further surgery.that the plaque can occur in any part of the tunica 537

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