Book Review
Paediatric Gastroenterology
N Engl J Med 1993; 328:978-979April 1, 1993
- Article
Paediatric Gastroenterology
Edited by J. Navarro and J. Schmitz. 547 pp., illustrated. New York, Oxford University Press, 1992. $150. ISBN: 0-19-261771-0If the weight of a textbook bears any relation to the degree of expansion of a new specialty, then this new arrival from Paris, at a weight of 1.5 kg, signals a modest expansion in comparison with other books -- the 5.3-kg Pediatric Gastrointestinal Disease by Walker et al. (St. Louis: Mosby-Year Book, 1991), the 4.1-kg Textbook of Gastroenterology and Nutrition in Infancy by Lebenthal (2nd ed. New York: Raven Press, 1989), the 2.8-kg Pediatric Clinical Gastroenterology by Silverman and Roy (3rd ed. St. Louis: Mosby-Year Book, 1983), and the 1.3-kg Essentials of Pediatric Gastroenterology by Harries (2nd ed. New York: Churchill Livingstone, 1988). Certainly, two of the finest textbooks on diseases of the liver -- Sherlock and Dooley's Diseases of the Liver and Biliary System (9th ed. Boston: Blackwell Scientific, 1993) and Mowat's Liver Disorders in Childhood (2nd ed. Boston: Butterworth-Heinemann, 1987) -- are exemplified by their concise presentation of the facts.
Paediatric Gastroenterology is a very readable textbook with a strong clinical orientation and includes data from the authors' own experience, much of which has been published in the French literature. Most clinical disorders in pediatric gastroenterology are covered, and there are excellent chapters on the development of the digestive system that reflect the expertise of the editors. Although there are 30 contributors, the majority of the chapters were written by the editors, which results in a consistency of editorial style. Illustrations, figures, and diagrams are profuse and informative. Related surgical disorders and specialized investigative and therapeutic techniques, such as endoscopy, total parenteral nutrition, and elimination diets, are discussed.
My chief criticism is the lack of any information on pediatric liver disease, which should be an important component of any textbook entitled Paediatric Gastroenterology. The difficult differential diagnosis of neonatal cholestasis and the problems of infants with vomiting and jaundice due to various metabolic diseases receive cursory coverage. Indeed, there is no specific chapter entitled “Disorders of the Liver.” Perhaps European tradition separates the liver from gastroenterology; however, an older textbook by Anderson and Burke, Pediatric Gastroenterology (Boston: Blackwell Scientific, 1975), has two chapters, and Harries' textbook has five chapters, on the liver. The inclusion of comprehensive material on liver diseases adds to the strength of the textbooks by Walker et al., Lebenthal, and Silverman and Roy. Other areas that one would like to see mentioned or discussed in greater depth include AIDS enteropathy and the relevance of helicobacteria infection in pediatrics -- a controversial subject.
As a complete reference in this area, the textbook by Walker et al. remains the gold standard, but their two-volume set is large and expensive. Navarro and Schmitz's textbook is concise and highly readable and will be of interest to students, pediatricians, family practitioners, and gastroenterologists. Its chief drawback is that it must be supplemented with a book on pediatric hepatology.
John Lloyd-Still, M.D.
Children's Memorial Hospital, Chicago, IL 60614
