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Anal and Rectal Diseases Explained
  1. A Emmanuel

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E D Ehrenpreis. London: Remedica, 2003, £20.00, pp 215. ISBN 1 901346 67 6

Eli Ehrenpreis, a respected senior North American physician, has completed the latest volume in a series of “Explained” mini textbooks. The series is intended as a source of concise information for physicians. The content is comprehensive, including subjects often missed by physicians and surgeons alike, such as sexually transmitted anorectal conditions and anal neoplasia. The style is akin to highly structured student notes and as such the information provides more of an overview for trainees rather than the complete detail for higher level specialists. This brevity and tendency towards being didactic, while a strength in some respects, can result in certain deficiencies, in particular in the introductory section on anatomy and physiology. The emphasis is towards the American model in terms of the intensity of investigation. A possible improvement for future editions would be to “editorialise” to a greater degree in terms of suggesting orders of priority for investigation and management of common presentations.

A particular strength of the book is the complementary illustrations, in particular the elegantly executed line drawings. These provide an excellent demonstration of the occasionally confusing anatomical relations of the pelvic floor, and this is particularly evident in the chapters covering anal fistulae. Additionally, the profusion of clinical photographs and x rays will be of help to gastroenterologists whose speciality is not coloproctology.

Another great value of the book is the patient information section. This is laid out in a question and answer style for a number of common clinical problems and is particularly helpful for the general gastroenterologist/physician. The book’s foreword stresses the emphasis on recent updates, and as such some of the omissions (such as CT colonography, advances in surgery) are slightly disappointing. Nevertheless, the author is to be congratulated overall for his success in including such a wealth of information in a mere 200 pages of a pocket sized book.