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Emergency Abdominal Surgery.
  1. M R B KEIGHLEY

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    Emergency Abdominal Surgery. Edited by Jones PF, Krukowski Z, Youngson GG. (Pp 556; illustrated; £45.00) UK: Chapman & Hall, 1998. ISBN 0412819503 (HB).

    The clear track record of success ofEmergency Abdominal Surgery is proved by the publication of a third edition. The authors, who are all from Aberdeen, classify themselves as general surgeons and the book is dedicated to the general surgeons of the future. As we enter the millennium, general surgery is still vital to the management of unclassified surgical emergencies, and surgeons of all disciplines need to be trained in triage. Yet, ultimately, it is probable that few of the subjects in this book will remain the province of the general surgeon and many will be within the auspices of specialist service groups. However, although the days of the general surgeon who dealt with ruptured aneurysms may be over, but there is still a role for a surgeon to identify the physical signs and to direct the patient along the right route.

    This book tackles emergencies in children as well as adults. Furthermore, the emergency presentation of vascular disease, and gynaecological and urological disorders is also discussed and the entire spectrum of general surgery as seen in the accident and emergency department of a district general hospital is comprehensively reviewed. Whether surgery in the future will follow the same pattern is open to speculation but there is currently a need for an up to date general surgical text for trainees and consultant surgeons.

    The text is well illustrated and referenced, and I found the chapter devoted to the acute abdomen in pregnancy and the puerperium to be particularly valuable as this information is not readily available in other general surgical texts. The book achieves a good balance of guidance on when a generalist can tackle a problem safely and when it is best to stop; complex liver injuries are acknowledged as a problem best managed in a tertiary referral centre where all the available support facilities are operational.

    I congratulate the authors of this book for bringing together a third edition of this text and they are to be applauded for using specialists in the areas that they no longer feel comfortable tackling themselves—that is, emergencies in children, urological emergencies, vascular emergencies, gynaecological disorders, and medical aspects of the acute abdomen. They are also to be praised for acknowledging in their preface that, nowadays, vascular surgery should be performed by specialists as should colorectal emergency surgery. Nevertheless, the emphasis in this book is on the clarity of decision making, by generalists where appropriate, and by specialists when indicated; it will continue to be a valuable resource for surgeons in training as well as those in practice.

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