- Email: [email protected]
Atlas of Tumor Pathology. Tumors of the Pancreas
GASTROENTEROLOGY 1998;114:614–617
PRINT AND MEDIA REVIEWS Lawrence S. Friedman, M.D. Print and Media Review Editor Gastrointestinal Unit, Blake 456D Massachusetts General Hospital Boston, Massachusetts 02114
Atlas of Tumor Pathology. Tumors of the Pancreas. Volume 20. By Enrico Solcia, Carlo Capella, and Gunther Kloppel. 262 pp. $50.00. Armed Forces Institute of Pathology, Washington, D.C., 1997. ISBN 1-881041-29-8. The new edition of Atlas of Tumor Pathology, Tumors of the Pancreas, from the renowned series published by the Armed Forces Institute of Pathology is a superb compendium of all tumors and tumor-like lesions of the exocrine and endocrine pancreas. Although billed as an atlas and packaged modestly as a soft-cover volume, the book has a rich text that is clearly and succinctly written as well as extensively referenced. It confers order on a relatively complex and confusing area of diagnostic pathology in which many of the tumors are known by a variety of synonymous terms, often with redundant sounding names and carrying additional clinical monikers according to the syndromes they produce. The authors are to be applauded for the use of internationally standardized terminology for tumors and an internationally recognized staging system (with comparison to the Japanese staging classification less familiar to Americans and Europeans). For each tumor type, the discussion begins with a list of all synonyms followed by a review of the epidemiology, pathogenesis, and description of the clinical features. The pathological discussion follows, with details of both gross and microscopic findings that are extensively and beautifully illustrated. Histochemical, immunohistochemical, and ultrastructural features are documented. In some instances newer diagnostic techniques, either morphological or molecular, are discussed. Perhaps most helpful for the practicing surgical pathologist is the thorough discussion of the pathological differential diagnosis. Lastly, current treatment and prognosis are summarized. In addition to covering the tumors and tumor-like lesions of the pancreas, the atlas covers other pertinent topics, including the normal pancreas (development, gross anatomy, histology, and cytology) and specific diagnostic procedures, both clinical and pathological. Examples of the latter include clinical laboratory data, radiological evaluation, frozen sections, fineneedle aspirations, and pancreatic juice cytology. In all its aspects, the book is logically organized and indexed. Overall, the book is so well done that criticisms seem rather querulous. Although black and white illustrations undoubtedly help to keep the purchase price low (this book is a real bargain among pathology texts), the illustrations are so outstanding that they deserve to be reproduced in color. As it is, fewer than half of the photomicrographs and gross specimen photographs are printed in color. The layout of the book also suffers slightly because the reader has to flip pages to find figures referred to in the text. More charts on comparative differential diagnostic features would also have been helpful.
Perhaps the only serious complaint is the failure of the authors to include the most recent version of the TNM staging system of the American Joint Committee on Cancer and the International Union Against Cancer. The TNM staging system for pancreatic carcinomas was updated in 1997 and now includes a category for carcinoma in situ (pTis) as well as substratifications of the T1 and N1 categories. Bottom Line: Overall, this book is outstanding and the best of its kind. Like all the atlases (otherwise known as ‘‘fascicles’’) in the series published by the AFIP, Tumors of the Pancreas is written by pathologists and is intended primarily for pathologists. Nevertheless, the book would be a valuable resource for any physician, surgeon, or subspecialist who deals with pancreatic tumors. CAROLYN C. COMPTON, M.D., Ph.D. Department of Pathology Massachusetts General Hospital Boston, Massachusetts
Gastroenterology Electronic Reference and Review. Edited by Tadataka Yamada, David H. Alpers, Chung Owyang, Don W. Powell, and Fred E. Silverstein. $395.00. Lippincott-Raven Publishers, Philadelphia, Pennsylvania, 1997. ISBN 0-39758785-6. Imagine having a comprehensive textbook of gastroenterology, an atlas of gastrointestinal images, a self-assessment review of the textbook, and a self-assessment guide to the atlas all able to fit in the palm of your hand and weighing less than one ounce! You don’t have to imagine it—the Gastroenterology Electronic Reference and Review on CD-ROM accomplishes this feat. (Of course, you will have to insert the CD-ROM into a computer to access the information.) There is no need for me to review the content of the Textbook of Gastroenterology because it has already been aptly reviewed in these pages (Gastroenterology 1996;110:961–962 and 113; 1420, [Atlas of Gastroenterology: Self-Assessment Guide]). The other volumes are outstanding companions to the second edition of the textbook. The CD-ROM contains the complete and unabridged versions of all four texts. For those who use computers regularly, the OOB (‘‘out of the box’’) experience with a new software package is crucial. On opening the box, was everything there? Were the installation instructions clear? Did it work properly on the computer? Was it user-friendly? Could the package be used quickly, or did one have to pore through arcane manuals to understand it? I definitely had a good OOB experience with this CD-ROM. Simplicity is the key to this software package. I opened the box and found a single CD-ROM in a plastic ‘‘jewel’’ case . . . and nothing else! I was expecting an instruction manual, but
March 1998
none was present. I opened the jewel case, and found only 3 pages of instructions on the insert. With some trepidation, I followed the instructions to install the software on my old 486–66 MHz computer running Windows 3.1 with 16 MB of RAM. The installation worked without a hitch, and in just a few minutes I was looking at the main menu. This seemed too good to be true, so I also loaded it onto a Pentium 120-MHz machine running Windows 95. This installation also worked just fine. The CD-ROM can also be used on a Macintosh computer with System 7.1 or higher. Well, it was simple to install, but I was still worried about those ‘‘missing instructions.’’ I need not have worried. The interface is simple to use. The books can be chosen from icons on the left side of the screen, and navigational tools are along the top. A single click starts a search (a very convenient feature). The menus and much of the text are ‘‘hyperlinked,’’ so the reader can jump immediately from one place to another with a single mouse click. It feels like using an Internet browser. Other features such as bookmarks and personal preferences are controlled from the menu ribbon at the top of the screen. On-line help is available, but rarely needed. However, I recommend reading though the brief insert to see which features are available. The figures are particularly well done. They are displayed as ‘‘thumbnail’’ miniature versions alongside the text. If one clicks on them, the full size version—optimized for viewing on a computer screen—pops up. While not quite as good as the originals in the books, the figures are certainly satisfactory. The optimum viewing resolution was 1024 3 768 with 256 colors, but 800 3 600 with 256 colors worked just fine. One nice feature is that they can be copied and pasted onto slides or printed out. I pasted some into PowerPoint for Windows and it worked seamlessly. Tables are text versions, not scanned-in images of the textbook. Also, when text appears on figures, it has been optimized for computer viewing. There are a few minor problems with the software. Not surprisingly, the software is a little sluggish on a 486 machine. However, I was pleasantly surprised that it worked at all! The cursor does not change to an hourglass after making a selection, making the user wonder if the selection was recognized by the computer. The ,Page up. and ,Page down. keys do not function while reading text. Finally, the Atlas cross references the first edition of the textbook from 1991, not the second edition, the one included on the CD-ROM. Thus, hyperlinks are not possible. However, these are minor complaints overall. Besides fixing the problems, there are a few other improvements that would be nice. Putting a full page reference to the original book both on the screen and printouts would make referencing the original easier. A scoring system or even continuing medical education credits for the reviews would enhance the package. In addition to the hyperlinks to the references, it would be nice to have the full text of the references on a separate CD-ROM included as a part of the package. Bottom Line: This is a well-executed CD-ROM version of a set of classic gastroenterology textbooks. The CD-ROM version adds many features: cross-referencing using hyperlinks, a
PRINT AND MEDIA REVIEWS
615
simple yet effective search engine that can search one or more books at once, the ability to export images to other software packages, the ability to annotate the books or place bookmarks, and a small light package that takes up little shelf space and saves lots of trees. Putting these outstanding texts on CDROM adds tremendous value above and beyond the merit of the books themselves. Packages such as this one are a terrific way to purchase gastroenterology texts. BENJAMIN KREVSKY, M.D., M.P.H. Gastroenterology Section Temple University Hospital Philadelphia, Pennsylvania
Diseases of the Gastrointerstinal Tract and Liver. Third edition. Edited by David J. C. Shearman, Niall D. C. Finlayson, Michael Camilleri, and David C. Carter. 1518 pp. $299.00. Churchill Livingstone, London, England, 1997. ISBN 0-44305147-X. This book is written primarily for physicians in training and general practitioners, as well as for gastroenterologists who desire a text that incorporates both medical and surgical knowledge in a wide variety of gastroenterological and hepatic diseases. The first section thoroughly discusses investigative techniques used in the evaluation of gastrointestinal and hepatic diseases, ranging from radiological imaging to nuclear medicine and endoscopic techniques. Some of the techniques are described in too much detail; others such as endoscopic ultrasonography do not receive adequate attention. Relevant for the practitioner, the preparation of the patient and the indications, limitations, and pitfalls of interpreting the various tests are addressed in good detail, particularly in the section on barium studies. However, the endoscopic pictures are in black and white and are lacking in detail and clarity. Most of the following sections are organized around anatomic and functional regions. Chapters start with a comprehensive discussion of relevant anatomy and physiology as well as techniques for functional assessment of the organ structures, where necessary. All major and many minor areas of gastroenterology are covered, stretching from a thorough chapter on oral manifestations to esophageal, gastric, small intestinal, pancreatic, biliary, colonic, and anorectal diseases. Many functional disorders (from motility disorders to irritable bowel syndrome) are presented in detail, and their possible underlying pathophysiological mechanisms are examined. Surprisingly, nonulcer dyspepsia is not addressed, although it represents a significant problem in general and gastroenterological practice. The more generalized alimentary tract problems like gastrointestinal bleeding, the acute abdomen, human immunodeficiency viral and other infections, nutrition, and inflammatory bowel disease are presented in separate, very comprehensive chapters. The sections on hepatology are organized around clinical presentations, with chapters on acute viral hepatitis, fulminant liver failure, metabolic, toxic and alcoholic liver disease, as well as
616
PRINT AND MEDIA REVIEWS
chronic liver disease, with its many etiologies and aspects. Additional, detailed chapters deal with liver transplantation, miscellaneous other liver diseases, and complications of chronic liver disease, including entire chapters devoted to ascites, hepatic encephalopathy, and other organ dysfunction, all written by recognized authorities in their fields. Of special value are interspersed chapters on neuralhormonal integration of gut function, clinical chemistry in liver disease, and immunology and infection in hepatology, which provide the reader with clinically relevant information based on pathobiochemical and pathophysiological principles. Another strong feature of this book is the extensive discussion of surgical therapeutic options, no doubt the contribution of the surgical editor Sir David Carter. In balance with discussions of established medical and endoscopic therapies, the reader finds information on various surgical techniques, postsurgical considerations and complications, as well as practical topics like ‘‘stoma and pouch care’’ and ‘‘surgery, anesthesia, and the liver.’’ Some of the more recent (and admittedly, not yet fully established) endoscopic therapies have not found their way into this book, such as botulinum toxin for achalasia and argon plasma beam therapy for hemostasis, although the overall spectrum of management options is quite complete. The organization of the text occasionally appears confusing, due to the somewhat random distribution of topics within chapters and sections. A list of subheadings for each chapter at the beginning of each section would have been helpful. The text is supplemented adequately with informative tables and graphics as well as extensive and up-to-date reference lists for each chapter. Bottom Line: Overall, this book is a valuable addition to a general practitioner’s library and may be a helpful source of reference for many gastroenterologists because medical and surgical aspects of gastroenterology and hepatology are covered very comprehensively. By including contributors from Australia, the United Kingdom, and North America, the information provided represents a solid body of international expertise. Although this new edition lacks the detail of other wellestablished textbooks of gastroenterology or hepatology, it succeeds in compressing the ever-expanding knowledge base of the field into a single manageable volume. MARTIN HAHN, M.D. HUGO R. ROSEN, M.D. Department of Gastroenterology and Hepatology Oregon Health Sciences University Portland, Oregon
Inflammatory Bowel Diseases. Third edition. Edited by Robert N. Allen, Jonathan M. Rhodes, Stephen B. Hanauer, Michael R. B. Keighley, John Alexander-Williams, and Victor W. Fazio. 989 pp. $159.00. Churchill Livingstone, Inc., New York, New York, 1997. ISBN 0-443-05067-8. With major revisions in scope and depth, the third edition of Inflammatory Bowel Diseases can make a credible claim as the
GASTROENTEROLOGY Vol. 114, No. 3
premier text in a burgeoning field. So greatly expanded is this work from the previous edition published 7 years ago that one could truly view this as a new book altogether. This reference text has, from the start, been a collaboration between gastroenterologists and surgeons. The current edition is notable for the addition of two distinguished American editors, Stephen Hanauer and Victor Fazio, to a fine core of British editors. The work is all the richer for this transatlantic and crossdisciplinary ferment, and lends an even-handed approach to areas of controversy. This volume has not simply gained two editors, 354 pages, and an additional 3 pounds of heft. In an almost paradoxical feat, it has managed to sharpen its focus as well. The editors have wisely chosen to organize the book into broad sections divided into relatively small chapters covering well-circumscribed topics. Within each section one generally finds chapters with a broader perspective, helping to integrate the presented information. The editors have taken great care to prevent excessive repetition of the material and have succeeded in conveying a uniform style despite the large number of contributors. The result is a collection of sharply honed pieces, each of which is detailed enough to stand alone but capable as well of serving as part of the whole. No area of inflammatory bowel disease (IBD) is left uncovered, with sections devoted to history, pathogenesis, clinical diagnosis, natural history and prognosis, medical and surgical management, complications, and social and psychological aspects of these diseases. The section on clinical diagnosis is especially notable for the inclusion of a dozen separate chapters covering minor forms of IBD, such as collagenous, microscopic and lymphocytic colitis, and diversion colitis, as well as other important conditions in the differential diagnosis. This thorough approach, in addition to providing detailed information on the full range of IBD masqueraders, illuminates nicely the distinctions and similarities in mechanisms among these conditions. Although one chapter is dedicated to IBD in childhood, pediatric gastroenterologists may find the treatment of this important topic too brief. It is the elaborate writing on surgical management that most distinguishes this work from others in a strong field of all-encompassing IBD texts. Whereas most works on the topic typically devote one chapter to surgical management of each of the major forms of IBD, this volume devotes more than 300 pages over five sections, a veritable text within a text, to surgical issues. In the section entitled ‘‘Surgical Principles,’’ one finds a potpourri of discussions about incisions and approaches, the application of antimicrobials in the context of surgery, the special risks of thromboembolism in IBD, the benefits of a team approach, preservation of anorectal function, and the emerging role of laparoscopy in management. A chapter presenting the anecdotal perspective of coeditor John AlexanderWilliams on surgical maneuvers in Crohn’s disease is brief but replete with hard-won pearls of information. Individual sections on the surgical treatment of ulcerative colitis and Crohn’s disease provide separate chapters for each of a variety of clinical
March 1998
indications and surgical options, while two additional sections present detailed approaches to the management of surgical complications and stomas. A wealth of well-labeled line drawings, photographs of gross specimens, and radiographs add to the clarity of presentation and provide excellent clinicopathologic correlation. Of obvious interest to surgeons, these sections will also have enormous appeal to the consulting gastroenterologist, who arguably requires an appreciation of the applications and limitations of surgical approaches at least as good as that of his or her surgical counterpart. With the exponential pace of progress in IBD research, one might reasonably make the case that the best text to purchase is the one most recently published. I suspect, however, that
PRINT AND MEDIA REVIEWS
617
thisedition of Inflammatory Bowel Diseases will age gracefully. The structure and content of this book will long continue to provide an excellent framework for new findings. Bottom Line: Serious students of IBD will find this reference as complete as one could expect in a field where information is so rapidly expanding. The book would be equally at home on the shelf of a gastroenterologist or a surgeon and should become a standard in well-stocked medical libraries. BRUCE E. SANDS, M.D. Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease Massachusetts General Hospital Boston, Massachusetts
PRINT AND MEDIA REVIEWS Lawrence S. Friedman, M.D. Print and Media Review Editor Gastrointestinal Unit, Blake 456D Massachusetts General Hospital Boston, Massachusetts 02114
Atlas of Tumor Pathology. Tumors of the Pancreas. Volume 20. By Enrico Solcia, Carlo Capella, and Gunther Kloppel. 262 pp. $50.00. Armed Forces Institute of Pathology, Washington, D.C., 1997. ISBN 1-881041-29-8. The new edition of Atlas of Tumor Pathology, Tumors of the Pancreas, from the renowned series published by the Armed Forces Institute of Pathology is a superb compendium of all tumors and tumor-like lesions of the exocrine and endocrine pancreas. Although billed as an atlas and packaged modestly as a soft-cover volume, the book has a rich text that is clearly and succinctly written as well as extensively referenced. It confers order on a relatively complex and confusing area of diagnostic pathology in which many of the tumors are known by a variety of synonymous terms, often with redundant sounding names and carrying additional clinical monikers according to the syndromes they produce. The authors are to be applauded for the use of internationally standardized terminology for tumors and an internationally recognized staging system (with comparison to the Japanese staging classification less familiar to Americans and Europeans). For each tumor type, the discussion begins with a list of all synonyms followed by a review of the epidemiology, pathogenesis, and description of the clinical features. The pathological discussion follows, with details of both gross and microscopic findings that are extensively and beautifully illustrated. Histochemical, immunohistochemical, and ultrastructural features are documented. In some instances newer diagnostic techniques, either morphological or molecular, are discussed. Perhaps most helpful for the practicing surgical pathologist is the thorough discussion of the pathological differential diagnosis. Lastly, current treatment and prognosis are summarized. In addition to covering the tumors and tumor-like lesions of the pancreas, the atlas covers other pertinent topics, including the normal pancreas (development, gross anatomy, histology, and cytology) and specific diagnostic procedures, both clinical and pathological. Examples of the latter include clinical laboratory data, radiological evaluation, frozen sections, fineneedle aspirations, and pancreatic juice cytology. In all its aspects, the book is logically organized and indexed. Overall, the book is so well done that criticisms seem rather querulous. Although black and white illustrations undoubtedly help to keep the purchase price low (this book is a real bargain among pathology texts), the illustrations are so outstanding that they deserve to be reproduced in color. As it is, fewer than half of the photomicrographs and gross specimen photographs are printed in color. The layout of the book also suffers slightly because the reader has to flip pages to find figures referred to in the text. More charts on comparative differential diagnostic features would also have been helpful.
Perhaps the only serious complaint is the failure of the authors to include the most recent version of the TNM staging system of the American Joint Committee on Cancer and the International Union Against Cancer. The TNM staging system for pancreatic carcinomas was updated in 1997 and now includes a category for carcinoma in situ (pTis) as well as substratifications of the T1 and N1 categories. Bottom Line: Overall, this book is outstanding and the best of its kind. Like all the atlases (otherwise known as ‘‘fascicles’’) in the series published by the AFIP, Tumors of the Pancreas is written by pathologists and is intended primarily for pathologists. Nevertheless, the book would be a valuable resource for any physician, surgeon, or subspecialist who deals with pancreatic tumors. CAROLYN C. COMPTON, M.D., Ph.D. Department of Pathology Massachusetts General Hospital Boston, Massachusetts
Gastroenterology Electronic Reference and Review. Edited by Tadataka Yamada, David H. Alpers, Chung Owyang, Don W. Powell, and Fred E. Silverstein. $395.00. Lippincott-Raven Publishers, Philadelphia, Pennsylvania, 1997. ISBN 0-39758785-6. Imagine having a comprehensive textbook of gastroenterology, an atlas of gastrointestinal images, a self-assessment review of the textbook, and a self-assessment guide to the atlas all able to fit in the palm of your hand and weighing less than one ounce! You don’t have to imagine it—the Gastroenterology Electronic Reference and Review on CD-ROM accomplishes this feat. (Of course, you will have to insert the CD-ROM into a computer to access the information.) There is no need for me to review the content of the Textbook of Gastroenterology because it has already been aptly reviewed in these pages (Gastroenterology 1996;110:961–962 and 113; 1420, [Atlas of Gastroenterology: Self-Assessment Guide]). The other volumes are outstanding companions to the second edition of the textbook. The CD-ROM contains the complete and unabridged versions of all four texts. For those who use computers regularly, the OOB (‘‘out of the box’’) experience with a new software package is crucial. On opening the box, was everything there? Were the installation instructions clear? Did it work properly on the computer? Was it user-friendly? Could the package be used quickly, or did one have to pore through arcane manuals to understand it? I definitely had a good OOB experience with this CD-ROM. Simplicity is the key to this software package. I opened the box and found a single CD-ROM in a plastic ‘‘jewel’’ case . . . and nothing else! I was expecting an instruction manual, but
March 1998
none was present. I opened the jewel case, and found only 3 pages of instructions on the insert. With some trepidation, I followed the instructions to install the software on my old 486–66 MHz computer running Windows 3.1 with 16 MB of RAM. The installation worked without a hitch, and in just a few minutes I was looking at the main menu. This seemed too good to be true, so I also loaded it onto a Pentium 120-MHz machine running Windows 95. This installation also worked just fine. The CD-ROM can also be used on a Macintosh computer with System 7.1 or higher. Well, it was simple to install, but I was still worried about those ‘‘missing instructions.’’ I need not have worried. The interface is simple to use. The books can be chosen from icons on the left side of the screen, and navigational tools are along the top. A single click starts a search (a very convenient feature). The menus and much of the text are ‘‘hyperlinked,’’ so the reader can jump immediately from one place to another with a single mouse click. It feels like using an Internet browser. Other features such as bookmarks and personal preferences are controlled from the menu ribbon at the top of the screen. On-line help is available, but rarely needed. However, I recommend reading though the brief insert to see which features are available. The figures are particularly well done. They are displayed as ‘‘thumbnail’’ miniature versions alongside the text. If one clicks on them, the full size version—optimized for viewing on a computer screen—pops up. While not quite as good as the originals in the books, the figures are certainly satisfactory. The optimum viewing resolution was 1024 3 768 with 256 colors, but 800 3 600 with 256 colors worked just fine. One nice feature is that they can be copied and pasted onto slides or printed out. I pasted some into PowerPoint for Windows and it worked seamlessly. Tables are text versions, not scanned-in images of the textbook. Also, when text appears on figures, it has been optimized for computer viewing. There are a few minor problems with the software. Not surprisingly, the software is a little sluggish on a 486 machine. However, I was pleasantly surprised that it worked at all! The cursor does not change to an hourglass after making a selection, making the user wonder if the selection was recognized by the computer. The ,Page up. and ,Page down. keys do not function while reading text. Finally, the Atlas cross references the first edition of the textbook from 1991, not the second edition, the one included on the CD-ROM. Thus, hyperlinks are not possible. However, these are minor complaints overall. Besides fixing the problems, there are a few other improvements that would be nice. Putting a full page reference to the original book both on the screen and printouts would make referencing the original easier. A scoring system or even continuing medical education credits for the reviews would enhance the package. In addition to the hyperlinks to the references, it would be nice to have the full text of the references on a separate CD-ROM included as a part of the package. Bottom Line: This is a well-executed CD-ROM version of a set of classic gastroenterology textbooks. The CD-ROM version adds many features: cross-referencing using hyperlinks, a
PRINT AND MEDIA REVIEWS
615
simple yet effective search engine that can search one or more books at once, the ability to export images to other software packages, the ability to annotate the books or place bookmarks, and a small light package that takes up little shelf space and saves lots of trees. Putting these outstanding texts on CDROM adds tremendous value above and beyond the merit of the books themselves. Packages such as this one are a terrific way to purchase gastroenterology texts. BENJAMIN KREVSKY, M.D., M.P.H. Gastroenterology Section Temple University Hospital Philadelphia, Pennsylvania
Diseases of the Gastrointerstinal Tract and Liver. Third edition. Edited by David J. C. Shearman, Niall D. C. Finlayson, Michael Camilleri, and David C. Carter. 1518 pp. $299.00. Churchill Livingstone, London, England, 1997. ISBN 0-44305147-X. This book is written primarily for physicians in training and general practitioners, as well as for gastroenterologists who desire a text that incorporates both medical and surgical knowledge in a wide variety of gastroenterological and hepatic diseases. The first section thoroughly discusses investigative techniques used in the evaluation of gastrointestinal and hepatic diseases, ranging from radiological imaging to nuclear medicine and endoscopic techniques. Some of the techniques are described in too much detail; others such as endoscopic ultrasonography do not receive adequate attention. Relevant for the practitioner, the preparation of the patient and the indications, limitations, and pitfalls of interpreting the various tests are addressed in good detail, particularly in the section on barium studies. However, the endoscopic pictures are in black and white and are lacking in detail and clarity. Most of the following sections are organized around anatomic and functional regions. Chapters start with a comprehensive discussion of relevant anatomy and physiology as well as techniques for functional assessment of the organ structures, where necessary. All major and many minor areas of gastroenterology are covered, stretching from a thorough chapter on oral manifestations to esophageal, gastric, small intestinal, pancreatic, biliary, colonic, and anorectal diseases. Many functional disorders (from motility disorders to irritable bowel syndrome) are presented in detail, and their possible underlying pathophysiological mechanisms are examined. Surprisingly, nonulcer dyspepsia is not addressed, although it represents a significant problem in general and gastroenterological practice. The more generalized alimentary tract problems like gastrointestinal bleeding, the acute abdomen, human immunodeficiency viral and other infections, nutrition, and inflammatory bowel disease are presented in separate, very comprehensive chapters. The sections on hepatology are organized around clinical presentations, with chapters on acute viral hepatitis, fulminant liver failure, metabolic, toxic and alcoholic liver disease, as well as
616
PRINT AND MEDIA REVIEWS
chronic liver disease, with its many etiologies and aspects. Additional, detailed chapters deal with liver transplantation, miscellaneous other liver diseases, and complications of chronic liver disease, including entire chapters devoted to ascites, hepatic encephalopathy, and other organ dysfunction, all written by recognized authorities in their fields. Of special value are interspersed chapters on neuralhormonal integration of gut function, clinical chemistry in liver disease, and immunology and infection in hepatology, which provide the reader with clinically relevant information based on pathobiochemical and pathophysiological principles. Another strong feature of this book is the extensive discussion of surgical therapeutic options, no doubt the contribution of the surgical editor Sir David Carter. In balance with discussions of established medical and endoscopic therapies, the reader finds information on various surgical techniques, postsurgical considerations and complications, as well as practical topics like ‘‘stoma and pouch care’’ and ‘‘surgery, anesthesia, and the liver.’’ Some of the more recent (and admittedly, not yet fully established) endoscopic therapies have not found their way into this book, such as botulinum toxin for achalasia and argon plasma beam therapy for hemostasis, although the overall spectrum of management options is quite complete. The organization of the text occasionally appears confusing, due to the somewhat random distribution of topics within chapters and sections. A list of subheadings for each chapter at the beginning of each section would have been helpful. The text is supplemented adequately with informative tables and graphics as well as extensive and up-to-date reference lists for each chapter. Bottom Line: Overall, this book is a valuable addition to a general practitioner’s library and may be a helpful source of reference for many gastroenterologists because medical and surgical aspects of gastroenterology and hepatology are covered very comprehensively. By including contributors from Australia, the United Kingdom, and North America, the information provided represents a solid body of international expertise. Although this new edition lacks the detail of other wellestablished textbooks of gastroenterology or hepatology, it succeeds in compressing the ever-expanding knowledge base of the field into a single manageable volume. MARTIN HAHN, M.D. HUGO R. ROSEN, M.D. Department of Gastroenterology and Hepatology Oregon Health Sciences University Portland, Oregon
Inflammatory Bowel Diseases. Third edition. Edited by Robert N. Allen, Jonathan M. Rhodes, Stephen B. Hanauer, Michael R. B. Keighley, John Alexander-Williams, and Victor W. Fazio. 989 pp. $159.00. Churchill Livingstone, Inc., New York, New York, 1997. ISBN 0-443-05067-8. With major revisions in scope and depth, the third edition of Inflammatory Bowel Diseases can make a credible claim as the
GASTROENTEROLOGY Vol. 114, No. 3
premier text in a burgeoning field. So greatly expanded is this work from the previous edition published 7 years ago that one could truly view this as a new book altogether. This reference text has, from the start, been a collaboration between gastroenterologists and surgeons. The current edition is notable for the addition of two distinguished American editors, Stephen Hanauer and Victor Fazio, to a fine core of British editors. The work is all the richer for this transatlantic and crossdisciplinary ferment, and lends an even-handed approach to areas of controversy. This volume has not simply gained two editors, 354 pages, and an additional 3 pounds of heft. In an almost paradoxical feat, it has managed to sharpen its focus as well. The editors have wisely chosen to organize the book into broad sections divided into relatively small chapters covering well-circumscribed topics. Within each section one generally finds chapters with a broader perspective, helping to integrate the presented information. The editors have taken great care to prevent excessive repetition of the material and have succeeded in conveying a uniform style despite the large number of contributors. The result is a collection of sharply honed pieces, each of which is detailed enough to stand alone but capable as well of serving as part of the whole. No area of inflammatory bowel disease (IBD) is left uncovered, with sections devoted to history, pathogenesis, clinical diagnosis, natural history and prognosis, medical and surgical management, complications, and social and psychological aspects of these diseases. The section on clinical diagnosis is especially notable for the inclusion of a dozen separate chapters covering minor forms of IBD, such as collagenous, microscopic and lymphocytic colitis, and diversion colitis, as well as other important conditions in the differential diagnosis. This thorough approach, in addition to providing detailed information on the full range of IBD masqueraders, illuminates nicely the distinctions and similarities in mechanisms among these conditions. Although one chapter is dedicated to IBD in childhood, pediatric gastroenterologists may find the treatment of this important topic too brief. It is the elaborate writing on surgical management that most distinguishes this work from others in a strong field of all-encompassing IBD texts. Whereas most works on the topic typically devote one chapter to surgical management of each of the major forms of IBD, this volume devotes more than 300 pages over five sections, a veritable text within a text, to surgical issues. In the section entitled ‘‘Surgical Principles,’’ one finds a potpourri of discussions about incisions and approaches, the application of antimicrobials in the context of surgery, the special risks of thromboembolism in IBD, the benefits of a team approach, preservation of anorectal function, and the emerging role of laparoscopy in management. A chapter presenting the anecdotal perspective of coeditor John AlexanderWilliams on surgical maneuvers in Crohn’s disease is brief but replete with hard-won pearls of information. Individual sections on the surgical treatment of ulcerative colitis and Crohn’s disease provide separate chapters for each of a variety of clinical
March 1998
indications and surgical options, while two additional sections present detailed approaches to the management of surgical complications and stomas. A wealth of well-labeled line drawings, photographs of gross specimens, and radiographs add to the clarity of presentation and provide excellent clinicopathologic correlation. Of obvious interest to surgeons, these sections will also have enormous appeal to the consulting gastroenterologist, who arguably requires an appreciation of the applications and limitations of surgical approaches at least as good as that of his or her surgical counterpart. With the exponential pace of progress in IBD research, one might reasonably make the case that the best text to purchase is the one most recently published. I suspect, however, that
PRINT AND MEDIA REVIEWS
617
thisedition of Inflammatory Bowel Diseases will age gracefully. The structure and content of this book will long continue to provide an excellent framework for new findings. Bottom Line: Serious students of IBD will find this reference as complete as one could expect in a field where information is so rapidly expanding. The book would be equally at home on the shelf of a gastroenterologist or a surgeon and should become a standard in well-stocked medical libraries. BRUCE E. SANDS, M.D. Gastrointestinal Unit and Center for the Study of Inflammatory Bowel Disease Massachusetts General Hospital Boston, Massachusetts