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Abdominal Ultrasound
  1. N Power

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Mike Stocksley moved from a career in clinical ultrasound to teaching and is now senior lecturer in the Faculty of Health at South Bank University. His background as an educator is readily apparent in this excellent book which for him was clearly a labour of love.

Despite the increasing complexity of investigations available, ultrasound remains an important tool in the investigation of abdominal pathology. Its ready availability and resulting popularity do not however imply that it is a straightforward or simple skill. It is probably the most operator dependent imaging modality, and mastery of the underlying concepts, proper performance of a scan, awareness of normal appearances, detection of relevant findings, and their correlation into a unifying diagnosis requires not only appropriate training but also extensive hands-on experience. These factors are often under appreciated by physicians, and if there is one thing guaranteed to aggravate the busy radiologist, it is a request for a “quick ultrasound” or for one to “just have a look”.

Mr Stocksley clearly appreciates the complexities of the topic and has produced a book which, while quite short and inexpensive, manages to be both practical and informative. The opening chapter covers the basics including choice of probe, use of coupling gel, patient preparation, and scanning positions. There follows a straightforward explanation of the principles and applications of Doppler ultrasound; reading this chapter caused the reviewer to heartily wish that Mr Stocksley had been in close proximity while he was studying for his part 1 FRCR physics! Having dealt with the basics, the book proceeds with the nitty gritty of practical abdominal ultrasound and there are excellent chapters on the “usual suspects”: the liver, biliary tree, pancreas, spleen, and urinary tract, as well as more esoteric subjects such as the adrenal glands, muscle, and bowel. Each chapter is laid out similarly, with an initial description of functions and anatomy of the organ followed by the optimal scanning technique and normal ultrasound appearances before a discussion of pathology. The book is lavishly illustrated with over 250 illustrations, including line drawings, photographs to demonstrate scanning positions, and ultrasound images, with a nice balance between normal and pathological appearances. Advice boxes scattered throughout the text give useful tips on pitfalls to avoid, measures to improve scanning technique, and the relevance of findings.

Quibbles with this book are relatively minor. I would have welcomed a chapter on endoscopic ultrasound including endoanal; this area is underrepresented in the text. Also, one feels the clinical advice is in places oversimplistic: for example, in a table on abdominal pain, stating that “pain in both left sides and right=cancer” is of limited value. The impression that this book is predominantly aimed at ultrasonographers in training is reinforced by emphasis on such topics as planning an ultrasound room and report wording. However, these caveats aside, this is an excellent book which would be a useful purchase for any gastroenterologist wishing to expand their knowledge in this complex and ever changing field.

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