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Atlas of Gastroenterology Self- Assessment Guide

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Atlas of Gastroenterology Self- Assessment Guide. Yamada T, Alpers DH, Owyany C, Powell DW, Sliverstein FE. (Pp 368; illustrated; £46.00.) Philadelphia: Lippincott-Raven Publishers, 1996. ISBN 0-397-51788-2.

Yet another picture book of self-assessment anecdotes I hear you groan! This new book contains 98 cases which illustrate a whole range of gastrointestinal and hepato-biliary diagnoses. Most of the cases presented consist of common clinical problems, such as coeliac sprue and colonic polyps, with the occasional addition of diagnoses only rarely encountered in a clinician’s lifetime. The book is written in self-assessment format and is aimed at students sitting board exams as well as seasoned physicians. Although only a small book, it is not portable as the excellent but bulky companion textbooks—namely theTextbook of Gastroenterology and Atlas of Gastroenterology—are heavily referenced throughout and need to be close at hand.

The case presentations are succinct and contain only the relevant positive and negative aspects of each history with a minimum of laboratory data. The first page of each case provides a history, examination and laboratory results. The questions are then answered, discussed and referenced overleaf. The cases are grouped consecutively by the organ specific pathology involved, although the style of writing in each case varies quite considerably reflecting the large authorship behind this project.

The book takes into account advances in diagnostic methods now available to the gastroenterologist, and endoscopic ultrasound, spiral CT and manometric studies appear amongst more conventional images. The illustrations are of variable quality but their reproduction is improved by the high quality of the paper used. Many of the pictures are in black and white and are obviously taken from the archives of several different centres, presumably over a number of years.

Some physicians may find American text difficult to follow especially in the context of case history presentations as the abbreviation of results used is often unfamiliar, and yet thankfully this pitfall is avoided in this book which is globally user-friendly. The recommended management for each particular diagnosis remains slanted more towards an American audience and the model answers given may not appeal in every case to European gastroenterologists.

The authors state that it was their intention to ensure that this self-assessment guide stands out as a reference book in its own right. The text is not comprehensive enough for this to have been achieved and it is essential that the sister reference texts are close to hand. It may have also been helpful to quote some evidence based on original papers rather than just from other textbooks. Any book which wishes to be considered as a reference volume or as accessible to a general physician requires an index and sadly none exists in this book. The layout of each case results in large gaps being left on each page which might be used by the reader to make additional notes about each diagnosis.

This is one of the few case study books currently available in gastroenterology and is sure to test the diagnostic skills of both medical student and seasoned clinician the first time it is read. In general, these books are never such a good read the second time around as the plot is known for each case.

As it is expensive this book may be beyond the buying power of junior trainees who paradoxically might benefit most from its contents. However, it should also be considered as a valuable study aid for medical students, physicians and nurses alike, especially if available from an institutional library.