Acute Disorders of the Abdomen: Diagnosis and Treatment

This highly readable handbook of acute abdominal disorders will be useful to medical students and housestaff in both medical and surgical specialties. As Dr. Sreenivas mentions in his preface, the book is designed to provide medical practitioners with a "core knowledge" of the acute abdomen, "necessary for early recognition and proper management of patients." The author succeeds in achieving his goal. The book is divided into two sections. In the first section, Dr. Sreenivas addresses the general approach to the acute abdomen. He emphasizes the need to ascertain whether a patient needs hospitalization and/or an operation, as opposed to determining the specific diagnosis. Basic neuroanatomic considerations of pain and reflexes are mentioned in one chapter. There is an excellent discussion of the history and physical examination of the acute abdomen. Imaging studies are discussed and include the abdominal X-ray, chest X-ray, and sonography. Special procedures and radioisotope scans are mentioned briefly. The chapter on imaging procedures is supplemented by eleven black-and-white plates, including X-rays of the normal abdomen. A chapter on laboratory studies emphasizes the most common, inexpensive tests and their use in the diagnosis of the acute abdomen. The second section of the handbook looks specifically at each of seventeen conditions which may be associated with an acute abdomen. In each instance, Dr. Sreenivas follows a highly organized formula for the description of the illness. The surgeon discusses the etiology and pathophysiology of each disorder as well as its presenting features, and laboratory and X-ray findings. Diagnosis and management are also discussed. The organization of the second section serves to reinforce the general considerations of the first section. An excellent concluding chapter outlines several non-surgical illnesses which could be mistaken for an acute abdomen. It is concise and organized by medical system. Acute Disorders of the Abdomen is a very useful handbook and introduction to general surgical diagnostic reasoning. While not comprehensive, its two hundred pages highlight the most common of the acute abdominal disorders. It is graphically appealing, with wide margins suitable for writing notes, as well as frequent subheadings in the margins, which enhance the book's organization. Each chapter is supplemented by several references. Thirty X-rays are very illustrative. Dr. Sreenivas' book should be on the bookshelves of all medical students and houseofficers.