Diarrhea is common after liver transplantation (LT).

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SUMMARYBackground: Mesenteric panniculitis is a rare condition with no standard therapy. Aim: To assess the safety and efficacy of thalidomide for the treatment of patients with symptomatic mesenteric panniculitis using a newly established clinical disease activity index (Mesenteric Panniculitis Subjective Assessment Score). Methods:In an open-label pilot study, five patients with symptomatic mesenteric panniculitis received oral thalidomide, 200 mg nightly, for 12 weeks. The primary end-point was a reduction in the Mesenteric Panniculitis Subjective Assessment Score by ‡ 20% at 12 weeks or complete remission (absence of symptoms).

We preoperatively determined the accuracy of 18 F-FDG PET/CT for differentiating fixed muscle hypertrophy and fibrotic stenoses from acute transmural inflammatory stenoses in patients with Crohn's disease (CD) scheduled to undergo surgical resection for obstructive symptoms. Methods: Seventeen patients with known CD prospectively underwent 18 F-FDG PET/CT before already-planned surgery for obstructive symptoms. Image interpretation was by consensus of 2 readers with knowledge of patient participation in the study but not of other clinical history. Lesions were qualitatively graded on a 5-point scale for the presence of increased 18 F-FDG uptake consistent with active inflammation. Maximum lean standardized uptake value (SUL max ) was determined for lesions scored 1 or more. Imaging results were compared with the pathologic grading of inflammation and predominant histopathologic subtype for each patient's surgical specimen, whether mainly inflammation, fibrosis, or muscle hypertrophy. Results: Thirteen of the 17 patients underwent surgery (median, 28 d after PET/CT; range, 2-148 d), and 12 of these 13 had histopathologic correlation. Despite the predominant histopathologic subtype (inflammation, 5; fibrosis, 4; and muscle hypertrophy, 3), acute and chronic inflammation, fibrosis (median, 50%; range, 40%290%), and muscle hypertrophy (median, 20-fold thickening; range, 9-to 40-fold thickening) were found in all patients. SUL max was significantly higher in severe than in mild-to-moderate chronic inflammation (8.2 6 2.8 vs. 4.7 6 2.5, P 5 0.04). No patient with predominantly fibrosis or muscle hypertrophy (n 5 7) had an SUL max greater than 8. Visually, 10 of 12 patients on PET/CT were considered to have active inflammation of the bowel. Conclusion: Patients with CD who undergo surgery for obstructive symptoms have histopathologically mixed findings of inflammation, fibrosis, and muscle hypertrophy. Qualitative PET interpretations were quite sensitive, but additional semiquantitative analyses using SUL max helped identify patients with active inflammation. This information may be beneficial for referring gastroenterologists considering medical therapy versus surgery for patients with CD who present with obstructive symptoms.