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The large intestine: Physiology, pathophysiology and disease
GASTROENTEROLOGY
1992;102:1820-1821
BOOK REVIEWS Helen M. Shields, M.D.
Book Review Editor Beth Israel Hospital 330 Brookline Avenue Boston, Massachusetts 02215
The Large Intestine: Physiology, Pathophysiology and Disease. Edited by Sidney F. Phillips, John H. Pemberton, and Roy G. Shorter. 923 pp. $195.00. Raven Press, New York, New York, 1991. ISBN O-88167-777-9. This textbook provides physicians interested in colonic disorders with a thorough review of basic science and a survey of common diseases affecting the large intestine. A scholarly text devoted to the colon is long overdue because surgeons, gastroenterologists, and internists are now spending a large percentage of their time and efforts on diseases that affect this somewhat unglamorous organ. The authors, all distinguished staff members of the Mayo Clinic, have organized the book into three main sections dealing with basic science, mechanisms of disease, and clinically oriented topics. Section I, dealing with the expanding base of basic science knowledge, is entitled “Structure and Function of the Large Intestine.” Topics covered include development, anatomy, bacteriology, motility, ion and water transport, and response to injury. These chapters are richly illustrated and referenced and provide a scholarly review of basic physiology. The middle section, “General Clinical Features of Colorectal Disease,” includes chapters on epidemiology, dietary fiber, radiology and endoscopy of the colon, diagnostic testing, biopsies, and screening for coionic diseases. While generally well written, several chapters tend to provide lists of conditions with an expository text, rather than providing a scholarly review. The chapter on colonoscopy is only 10 pages long, while radiology of the colon receives 17 pages, even though the primary diagnostic modality in many colonic disorders is colonoscopy. The lack of any illustrations in the chapter on colonoscopy was disappointing, because this is basically a visual technique. As expected in this multiauthored textbook, the reader will encounter considerable redundancy. The diagnostic evaluation of rectal bleeding is covered in three separate chapters, although not in the same detail. Section III comprises 25 chapters directed at specific coionic diseases. Again, the editors have emphasized some areas at the expense of others. For example, constipation and incontinence are allotted five chapters, while the inflammatory bowel diseases are covered in four. This imbalance may reflect the referral patterns at the Mayo Clinic and the research interests of the editors. In general, this part of the book, which most readers will cover in detail, is well written and illustrated. The chapter on colonic parasites is richly illustrated with color plates of organisms and their clinical effects. The chapters on inflammatory bowel disease cover the usual aspects of etiology and medical and surgical therapy, but the natural history of Crohn’s disease and ulcerative colitis and the variety of their clinical presentations are not covered in sufficient detail. A brief
chapter, “Challenges in Inflammatory Bowel Disorders,” is interesting and well written but seems out of place in a textbook of this nature. Another notable deficiency is the lack of detailed discussion of the local and systemic complications of inflammatory bowel disease. Although it is a minor entity, bypass or diversion colitis is scarcely mentioned. The chapter “Surgical Therapy of IBD” does not provide adequate coverage of the management of toxic megacolon. In summary, the strengths of this new text are the detailed and authoritative chapters on structure and function of the large intestine and the general discussions of pathophysiology. For the first time, the interested reader can find a variety of topics related to colonic diseases in a single comprehensive book. The main shortcomings are the spotty coverage of certain important topics and the overemphasis of others such as constipation, which may reflect the referral bias at the editors’ institution. This book will be a welcome addition to hospital, medical school, and specialty unit libraries. J. THOMAS
LAMONT,
M.D.
The University Hospital Boston University School of Medicine Boston, Massachusetts Gastrointestinal Infection and AIDS: Unit 6 of the AGA Clinical Teaching Project. By Thomas L. Treadwell, Mark Peppercorn, and Raymond Koff. 117 slides. $150.00. Milner-Fenwick, Timonium, Maryland, 1991. This collection of high-quality slides and accompanying text in a separate handbook is the newest unit derived from the work of the clinical teaching project of the American Gastroenterological Association. It comprises computer-derived diagrams, microbiological and endoscopic photographs, and histopathologic specimens that depict bacterial, viral, and protozoa1 infectious processes in 117 slides collected into convenient loose-leaf plastic sheet holders. It is designed as a resource for teaching medical students, for house staff in continuing medical education, and for health care workers. The slides represent a cornucopia of information for almost all forms of microbial infection of the gastrointestinal tract. Many are outstanding representations of disease, especially those depicting endoscopy appearances (slides 4, 8,10,39, 73, and 99) and clinical manifestations (slides 1,2, 7, 37, 103, and 105). The title of the project, however, is somewhat misleading, because there are very few slides specifically related to human immunodeficiency virus (HIV) infection. The whole collection is also not structured around acquired immunodeficiency syndrome (AIDS) as the main condition in which these infections are encoun-
1992;102:1820-1821
BOOK REVIEWS Helen M. Shields, M.D.
Book Review Editor Beth Israel Hospital 330 Brookline Avenue Boston, Massachusetts 02215
The Large Intestine: Physiology, Pathophysiology and Disease. Edited by Sidney F. Phillips, John H. Pemberton, and Roy G. Shorter. 923 pp. $195.00. Raven Press, New York, New York, 1991. ISBN O-88167-777-9. This textbook provides physicians interested in colonic disorders with a thorough review of basic science and a survey of common diseases affecting the large intestine. A scholarly text devoted to the colon is long overdue because surgeons, gastroenterologists, and internists are now spending a large percentage of their time and efforts on diseases that affect this somewhat unglamorous organ. The authors, all distinguished staff members of the Mayo Clinic, have organized the book into three main sections dealing with basic science, mechanisms of disease, and clinically oriented topics. Section I, dealing with the expanding base of basic science knowledge, is entitled “Structure and Function of the Large Intestine.” Topics covered include development, anatomy, bacteriology, motility, ion and water transport, and response to injury. These chapters are richly illustrated and referenced and provide a scholarly review of basic physiology. The middle section, “General Clinical Features of Colorectal Disease,” includes chapters on epidemiology, dietary fiber, radiology and endoscopy of the colon, diagnostic testing, biopsies, and screening for coionic diseases. While generally well written, several chapters tend to provide lists of conditions with an expository text, rather than providing a scholarly review. The chapter on colonoscopy is only 10 pages long, while radiology of the colon receives 17 pages, even though the primary diagnostic modality in many colonic disorders is colonoscopy. The lack of any illustrations in the chapter on colonoscopy was disappointing, because this is basically a visual technique. As expected in this multiauthored textbook, the reader will encounter considerable redundancy. The diagnostic evaluation of rectal bleeding is covered in three separate chapters, although not in the same detail. Section III comprises 25 chapters directed at specific coionic diseases. Again, the editors have emphasized some areas at the expense of others. For example, constipation and incontinence are allotted five chapters, while the inflammatory bowel diseases are covered in four. This imbalance may reflect the referral patterns at the Mayo Clinic and the research interests of the editors. In general, this part of the book, which most readers will cover in detail, is well written and illustrated. The chapter on colonic parasites is richly illustrated with color plates of organisms and their clinical effects. The chapters on inflammatory bowel disease cover the usual aspects of etiology and medical and surgical therapy, but the natural history of Crohn’s disease and ulcerative colitis and the variety of their clinical presentations are not covered in sufficient detail. A brief
chapter, “Challenges in Inflammatory Bowel Disorders,” is interesting and well written but seems out of place in a textbook of this nature. Another notable deficiency is the lack of detailed discussion of the local and systemic complications of inflammatory bowel disease. Although it is a minor entity, bypass or diversion colitis is scarcely mentioned. The chapter “Surgical Therapy of IBD” does not provide adequate coverage of the management of toxic megacolon. In summary, the strengths of this new text are the detailed and authoritative chapters on structure and function of the large intestine and the general discussions of pathophysiology. For the first time, the interested reader can find a variety of topics related to colonic diseases in a single comprehensive book. The main shortcomings are the spotty coverage of certain important topics and the overemphasis of others such as constipation, which may reflect the referral bias at the editors’ institution. This book will be a welcome addition to hospital, medical school, and specialty unit libraries. J. THOMAS
LAMONT,
M.D.
The University Hospital Boston University School of Medicine Boston, Massachusetts Gastrointestinal Infection and AIDS: Unit 6 of the AGA Clinical Teaching Project. By Thomas L. Treadwell, Mark Peppercorn, and Raymond Koff. 117 slides. $150.00. Milner-Fenwick, Timonium, Maryland, 1991. This collection of high-quality slides and accompanying text in a separate handbook is the newest unit derived from the work of the clinical teaching project of the American Gastroenterological Association. It comprises computer-derived diagrams, microbiological and endoscopic photographs, and histopathologic specimens that depict bacterial, viral, and protozoa1 infectious processes in 117 slides collected into convenient loose-leaf plastic sheet holders. It is designed as a resource for teaching medical students, for house staff in continuing medical education, and for health care workers. The slides represent a cornucopia of information for almost all forms of microbial infection of the gastrointestinal tract. Many are outstanding representations of disease, especially those depicting endoscopy appearances (slides 4, 8,10,39, 73, and 99) and clinical manifestations (slides 1,2, 7, 37, 103, and 105). The title of the project, however, is somewhat misleading, because there are very few slides specifically related to human immunodeficiency virus (HIV) infection. The whole collection is also not structured around acquired immunodeficiency syndrome (AIDS) as the main condition in which these infections are encoun-