Book Review

Acute Abdomen: Diagnostic imaging in the clinical context

N Engl J Med 1996; 335:1775December 5, 1996

Article

Acute Abdomen: Diagnostic imaging in the clinical context
By Gabriel P. Krestin and Peter L. Choyke, with contributions by 16 others. 285 pp., illustrated. New York, Thieme, 1996. $49. ISBN: 0-86577-606-7

This book has 14 symptom-oriented chapters (on topics such as right-upper-quadrant pain, diarrhea, and trauma). Each chapter gives a brief discussion of the clinical presentation, followed by a review of relevant radiologic studies grouped according to differential diagnostic considerations. For example, the chapter on right-lower-quadrant pain reviews appendicitis, mesenteric lymphadenitis, inflamed Meckel's diverticulum, cecal diverticulitis, typhlitis, and ileocecal tuberculosis. The text is brief, emphasizing the capabilities of each imaging technique rather than describing typical radiologic findings. That information is provided by illustrations of characteristic examples. In general the illustrations are appropriate, and the quality of the images is quite good. A particularly useful feature is the complete differential diagnosis that appears on the first page of each chapter for the symptom under consideration. The radiologic imaging of common diagnostic possibilities is discussed in the chapter, but for the remaining diagnoses page numbers are provided, allowing the reader to find information in other chapters. This format prevents the duplication of material while permitting thoroughness.

An important limitation of the book is its lack of detail on the sensitivity and specificity of the imaging tests. However, to help the reader select appropriate tests, each chapter ends with a recommended diagnostic algorithm. A few pertinent references are also provided. Separate chapters cover pediatric disorders and extraabdominal causes of acute abdomen.

The book's strengths are its brevity and its unusual organization. However, it assumes that the reader is generally familiar with the subject and will use the book only as a guide. Hence, the book is likely to be of most benefit to experienced physicians and nonphysician providers. It would be best used as a reference guide in an emergency room or walk-in clinic.

Sanjay Saini, M.D.
Massachusetts General Hospital, Boston, MA 02114

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