- Email: [email protected]
Atlas of Gastroenterology: Self-Assessment Guide
Book reviews
Current Topics in Gastrointestinal Pharmacology edited by James H. Lewis and Andres Dubois Blackwell Science Inc., Malden, Massachusetts, 1997, 342 pp., $75.00
Figure 1. EUS image (7.5 MHz) of a gastric inflammatory fibroid polyp. Note the hypoechoic lesion with an indistinct border lying within the third sonographic layer.
At EUS, a smooth, partially pedunculated, submucosalappearing lesion was again noted in the antrum. No ulcers or umbilications were seen at this examination. EUS with the Olympus GFUM20 echoendoscope (Olympus America, Inc., Melville, N.Y.) demonstrated a 1 to 1.5 cm hypoechoic homogeneous nodule in the second and third sonographic layers, with an intact fourth layer. The margin of the lesion was indistinct (Fig. 1) After EUS, the lesion was completely removed by standard electrosurgical snare polypectomy. At microscopic examination there was fibrous tissue with scattered inflammatory cells typical of an inflammatory fibroid polyp. Matsushita et al. 1 described 10 patients with gastric inflammatory fibroid polyps. On EUS, the most common findings were a hypoechoic, homogeneous nodule of the second and third sonographic layers, 1 to 2 cm in diameter, and with an indistinct margin. This case demonstrates these same EUS features. Additionally, it illustrates that these polyps can ulcerate, can present in association with iron deficiency anemia, and can be confused endoscopically with other submucosal lesions such as stromal tumors. It is likely that the ulcerated area healed in response to treatment with omeprazole before EUS. EUS is useful in ruling out other lesions located beneath the mucosa and selecting patients for endoscopic resection.
This multiauthored volume is the first of what promises to be a series of in-depth reviews in gastrointestinal and liver pharmacology. It is worth the reader's perusal and use as a reference work. Organized as 12 topic-oriented chapters with contributions from 18 authors (including the two editors), it is a powerful yet compact source of relatively up-todate information regarding our treatment armamentarium for many gastrointestinal and liver diseases. The reader will find reviews on conscious sedation for endoscopic procedures, an in-depth coverage of H2 receptor antagonists including their over the counter use, the medical therapy ofinfiammatory bowel disease, the pharmacologic treatment of portal hypertension and viral hepatitis among others. The main drawback of this book is its short shelf-life given the rapidity of changes (not necessarily advances) in pharmacotherapy. The chapter covering antibiotic prophylaxis of endoscopic procedures gives a nice historical summary of this practice. Several tables of recommended guidelines are dated, however (1990, 1995), and the issue of antibiotic prophylaxis for PEG placement in patients with ventriculoperitoneal shunts is not addressed. The chapter on antiemetic and prokinetic agents is particularly well written. In the chapter on antimicrobial therapy for H. pylori, lansoprazole is given only brief mention. In the chapter subsection on the safety of proton pump inhibitors the effect of PPI's on vitamin BIZ absorption are not mentioned. Despite minor drawbacks, this book will be useful for senior residents in medicine, gastroenterology fellows, and practicing gastroenterologists wishing to stay current in the field all for the price of a dinner for two in a good restaurant. Paul Miskovitz, MD
Douglas O. Faigel, MD Portland VA Medical Center, Oregon Health Sciences University Portland, Oregon
REFERENCES 1. Matsushita M, Hajiro K, Okazaki K, Takakuwa H. Gastric inflammatory fibroid polyps: endoscopic ultrasonographic analysis in comparison with the history. Gastrointest Endosc 1997;46:53-7.
VOLUME 47, NO.3, 1998
New York, New York
Atlas of Gastroenterology: Self-Assessment Guide edited by Tadataka Yamada Lippincott-Raven, Philadelphia, 1997, 349 pp., $59.95
Dr. Yamada and his associate editors developed the Atlas of Gastroenterology as a companion to GASTROINTESTINAL ENDOSCOPY 325
News & Notices
their Textbook of Gastroenterology to provide graphic presentations of the multiple imaging modalities used in the current practice of gastroenterology. The Self-Assessment Guide for the Atlas of Gastroenterology has been created to be both a "stand-alone reference" and a companion to the Textbook and Atlas. The book contains 97 case studies. Each section begins with a brief clinical presentation followed by pictorial material. The latter includes a broad range of endoscopic pictures, x-ray films, photomicrographs, motility studies, and photographs of physical findings. A self test is provided for each case followed by a relatively short discussion of the correct answers. The editors and their contributors have prepared a volume that is superior in content and presentation. The cases covered a broad range of topics including both common and relatively rare examples. The case presentations are short and understandable. The graphic material has been selected from the Atlas of Gastroenterology and is handsomely reproduced. The self tests are multiple choice questions. The correct answers are discussed and references are provided for both the Textbook and Atlas .. The discussions are the main strength of this book. They are uniformly well written and are extremely informative. The graphic material is described and concise explanations are given for both correct and incorrect answers. The discussions are so complete that it is generally not necessary to refer to either the Textbook or the Atlas. However the readily available references to these volumes are helpful if one wishes to further study the topic. This book will be valuable to many more gastroenterologists than those studying for board exams. The latter group will definitely find it useful to identify areas that will require further study. The guide clearly can be studied independently and the reader should have a challenging and interesting ~xperience. Thomas H. Browning, MD Madison, Wisconsin
Center, will provide the gastroenterologist and GI practice/endoscopic Ambulatory Surgery Centers (ASC) with information to succeed in the era of managed care. It will be offered April 2-4, 1998, at the Radisson Hotel, Knoxville, Tennessee. Contact Marilyn Bartling for registration information; phone: 423-558-0634.
Eighth International Workshop of Digestive Endoscopy, Ultrasonography and Radiology- Marseille, France This workshop will take place May 28-29, 1998, and will be directed by Professor J. Sahel. Contact Nathalie Fontant, Atelier Phenix, 41 Rue Docteur Morucci, 13006 Marseille, France; phone (33)491375083; fax (33)491-571528.
Tutorials in Advanced ERCPCharleston, South Carolina This tutorial, directed by Drs. Robert Hawes and Peter Cotton, will take place June 11-12, 1998, at the Digestive Disease Center, Medical University of South Carolina. It will include live demonstrations, didactics, videoclips, and discussion with additional contributions by John Cunningham, Mark Payne, Rig Patel, and Clive Kay. Contact Rita Oden; phone: 803-792-4165; fax: 803-792-4184.
Second Meeting of the European Club of Enteroscopy- Nancy, France This meeting will take place June 25-26, 1998, at the Hotel Altea and will be directed by Professor Gerard Gay. Contact Professor Gay, Service de Medecine L, Hopital Fournier, 54035 Nancy, cedex France; phone: (33)383-852404; fax: (33)383-852407; email: [email protected].
Tutorials in Endoscopic UltrasonographyCharleston, South Carolina
Gastroenterology, Managed Care, Endoscopic ASCs: Creating SuccessKnoxville, Tennessee This course, sponsored by the American Society for Gastrointestinal Endoscopy and the Endoscopy 326
GASTROINTESTINAL ENDOSCOPY
This tutorial, directed by Drs. Robert Hawes and Brenda Hoffman, will take place June 26-27, 1998, at the Digestive Disease Center, Medical University of South Carolina. It will include live demonstrations, didactics, videoclips, and "hands-on" lab with additional contributions by Clive Kay, Chris Kim, and Anand Sahai. Contact Rita Oden; phone: 803792-4165; fax: 803-792-4184. VOLUME 47, NO.3, 1998
Current Topics in Gastrointestinal Pharmacology edited by James H. Lewis and Andres Dubois Blackwell Science Inc., Malden, Massachusetts, 1997, 342 pp., $75.00
Figure 1. EUS image (7.5 MHz) of a gastric inflammatory fibroid polyp. Note the hypoechoic lesion with an indistinct border lying within the third sonographic layer.
At EUS, a smooth, partially pedunculated, submucosalappearing lesion was again noted in the antrum. No ulcers or umbilications were seen at this examination. EUS with the Olympus GFUM20 echoendoscope (Olympus America, Inc., Melville, N.Y.) demonstrated a 1 to 1.5 cm hypoechoic homogeneous nodule in the second and third sonographic layers, with an intact fourth layer. The margin of the lesion was indistinct (Fig. 1) After EUS, the lesion was completely removed by standard electrosurgical snare polypectomy. At microscopic examination there was fibrous tissue with scattered inflammatory cells typical of an inflammatory fibroid polyp. Matsushita et al. 1 described 10 patients with gastric inflammatory fibroid polyps. On EUS, the most common findings were a hypoechoic, homogeneous nodule of the second and third sonographic layers, 1 to 2 cm in diameter, and with an indistinct margin. This case demonstrates these same EUS features. Additionally, it illustrates that these polyps can ulcerate, can present in association with iron deficiency anemia, and can be confused endoscopically with other submucosal lesions such as stromal tumors. It is likely that the ulcerated area healed in response to treatment with omeprazole before EUS. EUS is useful in ruling out other lesions located beneath the mucosa and selecting patients for endoscopic resection.
This multiauthored volume is the first of what promises to be a series of in-depth reviews in gastrointestinal and liver pharmacology. It is worth the reader's perusal and use as a reference work. Organized as 12 topic-oriented chapters with contributions from 18 authors (including the two editors), it is a powerful yet compact source of relatively up-todate information regarding our treatment armamentarium for many gastrointestinal and liver diseases. The reader will find reviews on conscious sedation for endoscopic procedures, an in-depth coverage of H2 receptor antagonists including their over the counter use, the medical therapy ofinfiammatory bowel disease, the pharmacologic treatment of portal hypertension and viral hepatitis among others. The main drawback of this book is its short shelf-life given the rapidity of changes (not necessarily advances) in pharmacotherapy. The chapter covering antibiotic prophylaxis of endoscopic procedures gives a nice historical summary of this practice. Several tables of recommended guidelines are dated, however (1990, 1995), and the issue of antibiotic prophylaxis for PEG placement in patients with ventriculoperitoneal shunts is not addressed. The chapter on antiemetic and prokinetic agents is particularly well written. In the chapter on antimicrobial therapy for H. pylori, lansoprazole is given only brief mention. In the chapter subsection on the safety of proton pump inhibitors the effect of PPI's on vitamin BIZ absorption are not mentioned. Despite minor drawbacks, this book will be useful for senior residents in medicine, gastroenterology fellows, and practicing gastroenterologists wishing to stay current in the field all for the price of a dinner for two in a good restaurant. Paul Miskovitz, MD
Douglas O. Faigel, MD Portland VA Medical Center, Oregon Health Sciences University Portland, Oregon
REFERENCES 1. Matsushita M, Hajiro K, Okazaki K, Takakuwa H. Gastric inflammatory fibroid polyps: endoscopic ultrasonographic analysis in comparison with the history. Gastrointest Endosc 1997;46:53-7.
VOLUME 47, NO.3, 1998
New York, New York
Atlas of Gastroenterology: Self-Assessment Guide edited by Tadataka Yamada Lippincott-Raven, Philadelphia, 1997, 349 pp., $59.95
Dr. Yamada and his associate editors developed the Atlas of Gastroenterology as a companion to GASTROINTESTINAL ENDOSCOPY 325
News & Notices
their Textbook of Gastroenterology to provide graphic presentations of the multiple imaging modalities used in the current practice of gastroenterology. The Self-Assessment Guide for the Atlas of Gastroenterology has been created to be both a "stand-alone reference" and a companion to the Textbook and Atlas. The book contains 97 case studies. Each section begins with a brief clinical presentation followed by pictorial material. The latter includes a broad range of endoscopic pictures, x-ray films, photomicrographs, motility studies, and photographs of physical findings. A self test is provided for each case followed by a relatively short discussion of the correct answers. The editors and their contributors have prepared a volume that is superior in content and presentation. The cases covered a broad range of topics including both common and relatively rare examples. The case presentations are short and understandable. The graphic material has been selected from the Atlas of Gastroenterology and is handsomely reproduced. The self tests are multiple choice questions. The correct answers are discussed and references are provided for both the Textbook and Atlas .. The discussions are the main strength of this book. They are uniformly well written and are extremely informative. The graphic material is described and concise explanations are given for both correct and incorrect answers. The discussions are so complete that it is generally not necessary to refer to either the Textbook or the Atlas. However the readily available references to these volumes are helpful if one wishes to further study the topic. This book will be valuable to many more gastroenterologists than those studying for board exams. The latter group will definitely find it useful to identify areas that will require further study. The guide clearly can be studied independently and the reader should have a challenging and interesting ~xperience. Thomas H. Browning, MD Madison, Wisconsin
Center, will provide the gastroenterologist and GI practice/endoscopic Ambulatory Surgery Centers (ASC) with information to succeed in the era of managed care. It will be offered April 2-4, 1998, at the Radisson Hotel, Knoxville, Tennessee. Contact Marilyn Bartling for registration information; phone: 423-558-0634.
Eighth International Workshop of Digestive Endoscopy, Ultrasonography and Radiology- Marseille, France This workshop will take place May 28-29, 1998, and will be directed by Professor J. Sahel. Contact Nathalie Fontant, Atelier Phenix, 41 Rue Docteur Morucci, 13006 Marseille, France; phone (33)491375083; fax (33)491-571528.
Tutorials in Advanced ERCPCharleston, South Carolina This tutorial, directed by Drs. Robert Hawes and Peter Cotton, will take place June 11-12, 1998, at the Digestive Disease Center, Medical University of South Carolina. It will include live demonstrations, didactics, videoclips, and discussion with additional contributions by John Cunningham, Mark Payne, Rig Patel, and Clive Kay. Contact Rita Oden; phone: 803-792-4165; fax: 803-792-4184.
Second Meeting of the European Club of Enteroscopy- Nancy, France This meeting will take place June 25-26, 1998, at the Hotel Altea and will be directed by Professor Gerard Gay. Contact Professor Gay, Service de Medecine L, Hopital Fournier, 54035 Nancy, cedex France; phone: (33)383-852404; fax: (33)383-852407; email: [email protected].
Tutorials in Endoscopic UltrasonographyCharleston, South Carolina
Gastroenterology, Managed Care, Endoscopic ASCs: Creating SuccessKnoxville, Tennessee This course, sponsored by the American Society for Gastrointestinal Endoscopy and the Endoscopy 326
GASTROINTESTINAL ENDOSCOPY
This tutorial, directed by Drs. Robert Hawes and Brenda Hoffman, will take place June 26-27, 1998, at the Digestive Disease Center, Medical University of South Carolina. It will include live demonstrations, didactics, videoclips, and "hands-on" lab with additional contributions by Clive Kay, Chris Kim, and Anand Sahai. Contact Rita Oden; phone: 803792-4165; fax: 803-792-4184. VOLUME 47, NO.3, 1998