- Email: [email protected]
Manual of gastroenterology diagnosis and therapy
GASTROENTEROLOGY
BOOK
1989;96:262-5
REVIEWS
HOWARD M. SPIN), M.D. Book Revierz Editor
Yale University School of Medicine 333 Cedar Street, Box 3333 New Haven, Connecticut 06510
Dynamic Radiology of the Abdomen--Normal and Pathologic Anatomy. Third ed. By M. A. Meyers. 507 pp., 1061 figures, $110.00. Springer-Verlag, New York, New York, 1988. ISBN O-387-96624-2.
With 1061 illustrations, 14 in color and 230 new to this third edition, Morton A. Meyers has revised and updated his remarkable textbook on dynamic radiology of the abdomen. Many of the old line drawings and conventional radiographs are gone. A wealth of new material is supported by highly selective images including computed tomography and relevant magnetic resonance. This edition is divided into 12 chapters, each separately referenced and all well indexed. The introductory chapter on the normal anatomic relationships is preceded by 12 color plates. Coronal sections of frozen cadavers from the level of the 10th thoracic vertebra to the coccyx are presented. Familiarity with this material is essential to understand computed tomography of the abdomen. Chapter 1 deals briefly with the normal anatomy and variations of the diaphragm, the liver and spleen, the kidneys and adrenals, and the gastrointestinal tract. The extraperitoneal planes and tissues are briefly touched upon, about which more is to come in later chapters. Chapters 2 and 3, on the intraperitoneal spread of infections and malignancies, are profusely illustrated with line drawings, anatomic sections, peritoneography, and computed tomography. The wealth of material on the intraperitoneal spread of infection is a reflection of the times. Dr. Meyers believes that the marked increase in the incidence is related to “more prompt diagnosis of conditions such as peptic ulcer and appendicitis leading to ” I find this statement difficult earlier surgical intervention. to accept and think that delays in diagnosing perforated peptic ulcers or appendicitis should increase the incidence of postoperative abscesses. The chapter on intraperitoneal spread of malignancies is well done and illustrates the mode of spread of tumors across the bowel wall, around or through the supporting ligaments, and into the peritoneal cavity. Chapter 4, on the extraperitoneal spaces, is beautifully documented and illustrated, lacking only magnetic resonance imaging of the adrenals, which lend themselves so well to this modality. Effusions in both the anterior and posterior pararenal spaces are described at length and two useful tables listing the radiologic criteria for localization of fluid and gas in the extraperitoneal spaces are included. The remaining chapters describe and illustrate in great detail the renointestinal and duodenocolic relationships,
the effects of pancreatitis 011 its neighbors, the anatomy of the small bowel and colon, the intricacies of internal hernias, the pathways of extrapelvic spread of disease, and finally, some thoughts on the reading of plain films of the abdomen, surely a dying art. I cannot more highly recommend this third edition. The new material on the lesser sac and the pararenal fascia and spaces alone is worth the price.
Manual of Gastroenterology Diagnosis and ‘rheropj,. B! G. L. Eastwood and C. Avunduk. 366 pp., $19.50. Little. Brown and Company. Boston. Massachusetts, 1988. ISBN O-316-20397-1. This book provides a solid 347-page “pocket-sized” guide to the diagnosis and treatment of co~m~lon gastrointestinal problems. It is composed of 54 chapters grouped into five sections: (I) Approach to the Patient. (II) Diagnostic and Therapeutic Procedures, (III) Nutritional Assessment and Management, [IV) Gastrointestinal Emergencies. and (V) Specific Complaints and Disorders. The authors choose to devote minimal space. a conbined 7 pages, to the first section, which includes chapters on complaints and examination of the patient and the social, psychologic, and emotional impact of digestive disease. Instead, these topics are discussed as appropriate in relation to specific disorders. A similar treatment is given to procedures. Here. bowever, I was more interested in indications and guidelines for use of these procedures than the actual mechanics. of which most physicians are probably aware. IJnforturlately. in several instances, colonoscopy and the combination of barium enema and sigmoidoscopy seemed to be equated despite well-known problems with barium enema. The information on nutrition was useful and easily accessed, but once again the authors failed to note reservations, in this case about “renal” and “hepatic” diets. that many hold. The above-mentioned sections are in fact a small part of a text that is largely devoted to chapters on a wide range of subjects dealing with specific gastrointestinal symptoms, diseases, and disorders, as well as emergencies. These sections are appropriately the strength of this book. focusing on diagnosis and providing rational management guidelines, generally what. in my experience, people look for in these spiral-bound manuals.
lanuary
BOOK
1989
Overall, I found excellent clinical dents and house ology as well as seeking a practical have found other disappointed.
the Manual of Gastroenterology to be an aid and recommend it to medical stustaff doing elective work in gastroenterto general practitioners and internists and well-organized guide. Those who Little, Brown spirals helpful will not be
STEPHEN B. BHARUCHA
Yale Medical
School
REVIEWS
British surgeon John L. Craven, have put this book intelligible, if not colloquially American, English.
263
into
HOWARD SPIRO, M.D.
New Haven,
Connecticut
AGA Clinical Teaching pp., 83 slides, $125.00.
Project.
Unit 3: Viral Hepatitis.
50
1989
Review of Clinical Research in Gastroenterology. Edited by M. Maruyama and K. Kimura. 267 pp., $40.00. IgakuShoin, Tokyo, 1988. ISBN 0-89640-134-O. This very valuable treatise is badly named and for that reason will not receive the attention from clinical gastroenterologists that it really should. The book is not so much a review of clinical research in gastroenterology as it is a redo of papers from the Japanese language journal Stomach and Intestine. That journal apparently is an account of the meetings of the Japanese Society of Early Gastric Cancer. However, the papers in this volume are more than reprints and represent up-to-date accounts of what Japanese cliniciacs are doing and thinking about gastric and colon cancer, together with a few tidbits about other GI cancers. The Japanese clinicians do what gastroenterologists in the United States at least pledge to do, but we rarely live up to our ambitions. That is, correlate gross pathology, radiology, endoscopy, and increasingly ultrasonography, all in the same patient so that one has the opportunity to compare the worth of all these different approaches. In that way, the clinical utility of the magnificent modern diagnostic imaging armentarium can be assessed. This book provides astounding illustrations in all of these areas, beautiful enough to make me think of studying Japanese to work with clinicians who are so concerned about these matters. Gross pathology is still the mother of gastrointestinal practice, however many ultrastructure and cellular biological studies may seduce us and lead ultimately to cures. In that sense, this book is a tribute to the Japanese persistence in what may to some seem a 1940-1950 approach, but it still represents the clinical approach. Maybe not so much information can be gleaned from gross pathology as the Japanese suggest, in their greater reliance on gross morphology than on microscopic considerations, but after all, they have enormous experience. I only wish their predilection for classification schemes yielded a little to the western mind. Mine reels with letters, numbers, classification staging, and all the rest, and I put the book down, exhausted. I recommend this book highly for all endoscopists and oncologists. It should be in your libraries to be studied by anyone attempting to call himself or herself an endoscopist or gastrointestinal oncologist. My congratulations to editors Maruyama and Kimura who, with the help of
The AGA Clinical Teaching Project entitled Viral Hepatitis is the third in a series of slide/lecture units marketed by the AGA as a basis for lecturing “to just about any 83 colorful and clinically-oriented group.” It includes well-organized slides covering the broad topic of viral hepatitis. Coverage is almost equally divided with respect to hepatitis A, hepatitis B, and non-A, non-B hepatitis. For each of these topics the areas of epidemiology, clinical presentation, and preventative aspects are addressed. A few pathology slides are included. Brief sections are also devoted to hepatitis II and to fulminant hepatic failure. Equally important is the detailed text written to correspond to the individual slides. The text is in the form of a SO-page book that complements the slides with a brief but fact-filled paragraph for each slide that could easily be paraphrased to serve as the lecturer’s verbal accompaniment to his presentation. The slides and text provide so much detail that in fact they may yield a talk too lengthy to be given comfortably in a standard 45-SO-min format, but one should easily be able to edit the presentation for the appropriate audience. There are numerous current references cited throughout the text that enhance the scholarly approach and provide an added benefit, considering the nature of a slide series. Although not specifically stated, the unit seems best suited for a medical student/house officer/general medical audience. A few topics seem lengthier than needed for this level of presentation (e.g., four slides on the molecular biology of the hepatitis B virus). More frequently, however, questions that I feel are frequently asked by students and house officers, such as the interpretation of various hepatitis B serologies or recommendations for prophylaxis and immunization, are addressed in appropriate detail. If one were dealing with a more sophisticated GI-oriented audience, the available slides would require supplementation by the presenter. Some unresolved current controversies, such as screening for hepatocellular carcinoma or the use of antiviral and immunosuppressive therapies for chronic hepatitis, receive only scant attention. In summary, this Viral Hepatitis series follows in the tradition of the two previous AGA Clinical Teaching Projects (on inflammatory bowel disease and acute GI bleeding) of providing an excellent review lecture on its intended topic. It could easily stand alone as a presentation to a general medical audience or serve as a base for the lecturer to build upon for a more technical presentation. Educators should be eager to obtain this unit for themselves or their divisions. GREGORY F. BONNER. M.D
New Haven,
Connecticut
BOOK
1989;96:262-5
REVIEWS
HOWARD M. SPIN), M.D. Book Revierz Editor
Yale University School of Medicine 333 Cedar Street, Box 3333 New Haven, Connecticut 06510
Dynamic Radiology of the Abdomen--Normal and Pathologic Anatomy. Third ed. By M. A. Meyers. 507 pp., 1061 figures, $110.00. Springer-Verlag, New York, New York, 1988. ISBN O-387-96624-2.
With 1061 illustrations, 14 in color and 230 new to this third edition, Morton A. Meyers has revised and updated his remarkable textbook on dynamic radiology of the abdomen. Many of the old line drawings and conventional radiographs are gone. A wealth of new material is supported by highly selective images including computed tomography and relevant magnetic resonance. This edition is divided into 12 chapters, each separately referenced and all well indexed. The introductory chapter on the normal anatomic relationships is preceded by 12 color plates. Coronal sections of frozen cadavers from the level of the 10th thoracic vertebra to the coccyx are presented. Familiarity with this material is essential to understand computed tomography of the abdomen. Chapter 1 deals briefly with the normal anatomy and variations of the diaphragm, the liver and spleen, the kidneys and adrenals, and the gastrointestinal tract. The extraperitoneal planes and tissues are briefly touched upon, about which more is to come in later chapters. Chapters 2 and 3, on the intraperitoneal spread of infections and malignancies, are profusely illustrated with line drawings, anatomic sections, peritoneography, and computed tomography. The wealth of material on the intraperitoneal spread of infection is a reflection of the times. Dr. Meyers believes that the marked increase in the incidence is related to “more prompt diagnosis of conditions such as peptic ulcer and appendicitis leading to ” I find this statement difficult earlier surgical intervention. to accept and think that delays in diagnosing perforated peptic ulcers or appendicitis should increase the incidence of postoperative abscesses. The chapter on intraperitoneal spread of malignancies is well done and illustrates the mode of spread of tumors across the bowel wall, around or through the supporting ligaments, and into the peritoneal cavity. Chapter 4, on the extraperitoneal spaces, is beautifully documented and illustrated, lacking only magnetic resonance imaging of the adrenals, which lend themselves so well to this modality. Effusions in both the anterior and posterior pararenal spaces are described at length and two useful tables listing the radiologic criteria for localization of fluid and gas in the extraperitoneal spaces are included. The remaining chapters describe and illustrate in great detail the renointestinal and duodenocolic relationships,
the effects of pancreatitis 011 its neighbors, the anatomy of the small bowel and colon, the intricacies of internal hernias, the pathways of extrapelvic spread of disease, and finally, some thoughts on the reading of plain films of the abdomen, surely a dying art. I cannot more highly recommend this third edition. The new material on the lesser sac and the pararenal fascia and spaces alone is worth the price.
Manual of Gastroenterology Diagnosis and ‘rheropj,. B! G. L. Eastwood and C. Avunduk. 366 pp., $19.50. Little. Brown and Company. Boston. Massachusetts, 1988. ISBN O-316-20397-1. This book provides a solid 347-page “pocket-sized” guide to the diagnosis and treatment of co~m~lon gastrointestinal problems. It is composed of 54 chapters grouped into five sections: (I) Approach to the Patient. (II) Diagnostic and Therapeutic Procedures, (III) Nutritional Assessment and Management, [IV) Gastrointestinal Emergencies. and (V) Specific Complaints and Disorders. The authors choose to devote minimal space. a conbined 7 pages, to the first section, which includes chapters on complaints and examination of the patient and the social, psychologic, and emotional impact of digestive disease. Instead, these topics are discussed as appropriate in relation to specific disorders. A similar treatment is given to procedures. Here. bowever, I was more interested in indications and guidelines for use of these procedures than the actual mechanics. of which most physicians are probably aware. IJnforturlately. in several instances, colonoscopy and the combination of barium enema and sigmoidoscopy seemed to be equated despite well-known problems with barium enema. The information on nutrition was useful and easily accessed, but once again the authors failed to note reservations, in this case about “renal” and “hepatic” diets. that many hold. The above-mentioned sections are in fact a small part of a text that is largely devoted to chapters on a wide range of subjects dealing with specific gastrointestinal symptoms, diseases, and disorders, as well as emergencies. These sections are appropriately the strength of this book. focusing on diagnosis and providing rational management guidelines, generally what. in my experience, people look for in these spiral-bound manuals.
lanuary
BOOK
1989
Overall, I found excellent clinical dents and house ology as well as seeking a practical have found other disappointed.
the Manual of Gastroenterology to be an aid and recommend it to medical stustaff doing elective work in gastroenterto general practitioners and internists and well-organized guide. Those who Little, Brown spirals helpful will not be
STEPHEN B. BHARUCHA
Yale Medical
School
REVIEWS
British surgeon John L. Craven, have put this book intelligible, if not colloquially American, English.
263
into
HOWARD SPIRO, M.D.
New Haven,
Connecticut
AGA Clinical Teaching pp., 83 slides, $125.00.
Project.
Unit 3: Viral Hepatitis.
50
1989
Review of Clinical Research in Gastroenterology. Edited by M. Maruyama and K. Kimura. 267 pp., $40.00. IgakuShoin, Tokyo, 1988. ISBN 0-89640-134-O. This very valuable treatise is badly named and for that reason will not receive the attention from clinical gastroenterologists that it really should. The book is not so much a review of clinical research in gastroenterology as it is a redo of papers from the Japanese language journal Stomach and Intestine. That journal apparently is an account of the meetings of the Japanese Society of Early Gastric Cancer. However, the papers in this volume are more than reprints and represent up-to-date accounts of what Japanese cliniciacs are doing and thinking about gastric and colon cancer, together with a few tidbits about other GI cancers. The Japanese clinicians do what gastroenterologists in the United States at least pledge to do, but we rarely live up to our ambitions. That is, correlate gross pathology, radiology, endoscopy, and increasingly ultrasonography, all in the same patient so that one has the opportunity to compare the worth of all these different approaches. In that way, the clinical utility of the magnificent modern diagnostic imaging armentarium can be assessed. This book provides astounding illustrations in all of these areas, beautiful enough to make me think of studying Japanese to work with clinicians who are so concerned about these matters. Gross pathology is still the mother of gastrointestinal practice, however many ultrastructure and cellular biological studies may seduce us and lead ultimately to cures. In that sense, this book is a tribute to the Japanese persistence in what may to some seem a 1940-1950 approach, but it still represents the clinical approach. Maybe not so much information can be gleaned from gross pathology as the Japanese suggest, in their greater reliance on gross morphology than on microscopic considerations, but after all, they have enormous experience. I only wish their predilection for classification schemes yielded a little to the western mind. Mine reels with letters, numbers, classification staging, and all the rest, and I put the book down, exhausted. I recommend this book highly for all endoscopists and oncologists. It should be in your libraries to be studied by anyone attempting to call himself or herself an endoscopist or gastrointestinal oncologist. My congratulations to editors Maruyama and Kimura who, with the help of
The AGA Clinical Teaching Project entitled Viral Hepatitis is the third in a series of slide/lecture units marketed by the AGA as a basis for lecturing “to just about any 83 colorful and clinically-oriented group.” It includes well-organized slides covering the broad topic of viral hepatitis. Coverage is almost equally divided with respect to hepatitis A, hepatitis B, and non-A, non-B hepatitis. For each of these topics the areas of epidemiology, clinical presentation, and preventative aspects are addressed. A few pathology slides are included. Brief sections are also devoted to hepatitis II and to fulminant hepatic failure. Equally important is the detailed text written to correspond to the individual slides. The text is in the form of a SO-page book that complements the slides with a brief but fact-filled paragraph for each slide that could easily be paraphrased to serve as the lecturer’s verbal accompaniment to his presentation. The slides and text provide so much detail that in fact they may yield a talk too lengthy to be given comfortably in a standard 45-SO-min format, but one should easily be able to edit the presentation for the appropriate audience. There are numerous current references cited throughout the text that enhance the scholarly approach and provide an added benefit, considering the nature of a slide series. Although not specifically stated, the unit seems best suited for a medical student/house officer/general medical audience. A few topics seem lengthier than needed for this level of presentation (e.g., four slides on the molecular biology of the hepatitis B virus). More frequently, however, questions that I feel are frequently asked by students and house officers, such as the interpretation of various hepatitis B serologies or recommendations for prophylaxis and immunization, are addressed in appropriate detail. If one were dealing with a more sophisticated GI-oriented audience, the available slides would require supplementation by the presenter. Some unresolved current controversies, such as screening for hepatocellular carcinoma or the use of antiviral and immunosuppressive therapies for chronic hepatitis, receive only scant attention. In summary, this Viral Hepatitis series follows in the tradition of the two previous AGA Clinical Teaching Projects (on inflammatory bowel disease and acute GI bleeding) of providing an excellent review lecture on its intended topic. It could easily stand alone as a presentation to a general medical audience or serve as a base for the lecturer to build upon for a more technical presentation. Educators should be eager to obtain this unit for themselves or their divisions. GREGORY F. BONNER. M.D
New Haven,
Connecticut