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More About This Textbook
Overview
This classic text is much beloved by medical students and physicians-in-training throughout the English-speaking world, as its many editions indicate. It is chock full of the pearls of clinical wisdom that students and practitioners treasure, and many of these lessons apply to medicine in general. The book was well characterized by a reviewer of an earlier edition for The New England Journal of Medicine: 'If only one book about surgery could be made available to physicians from all specialties, it should probably be Silen's recent revision of Cope's Early Diagnosis of the Acute Abdomen. Since the book first appeared, it has remained the classic treatise on the initial approach to abdominal pain.' Because acute, severe abdominal pain is still a common problem whose misdiagnosis can result in quick death, each generation of beginning physicians is faced with the urgency of learning to make a diagnosis in this high-anxiety situation, and they appreciate the wise, humane, precisely detailed guidance offered by Cope and Silen. For the 22nd Edition, Dr. Silen has again updated the text in a respectful but significant way. He has added a chapter on the increasing disorder of diverticulitis, reexamines the use of analgesics, emphasizes the costs of over-testing, and updates all recommendations regarding trauma, radiologic studies, and therapeutic recommendations.
"...includes expanded discussion of the role of CT scans in diagnosing abdominal pain...less coverage of increasingly obsolete procedures & nosologic entities, like abdominal paracentesis, pyplyositis, and Bornholm's disease."
Editorial Reviews
From The Critics
Reviewer: Willem J de Villiers, MD, PhD, MHCM(University of Kentucky College of Medicine)Description: What does one say about the 21st edition of an authoritative clinical text first published in 1921? This revised edition by the eminent surgeon William Silen clearly demonstrates the beauty of succinct medical writing and the durability of clinical pearls. The previous edition was published in 2000 and the march of technology has continued relentlessly, threatening to overwhelm even the most ardent medical student's or resident's desire to obtain a complete history and perform a rigorous physical examination on patients presenting with symptoms and signs consistent with an acute abdomen.
Purpose: The purpose is to teach those features in the history and physical examination that lead to an accurate diagnosis of the underlying cause of abdominal pain and the acute abdomen. Specialized diagnostic tests are placed in context and over-reliance on these expensive modalities discouraged. The author makes these points admirably; however, in an increasingly technological world, the continued emphasis on history and physical diagnosis may appear somewhat quaint and old-fashioned.
Audience: The treatise is primarily aimed at medical students, surgical residents, and GI fellows. These groups will benefit the most, but many experienced gastroenterologists will also enjoy perusing this short, clearly written book which contains countless helpful clinical pearls. The author is an eminent, well-respected emeritus professor of surgery from Harvard Medical School.
Features: A logical approach is used to decipher the vast differential diagnosis of the acute abdomen in a logical, thought-provoking fashion. The chapter dealing with synthesis of different symptoms and signs to arrive at a diagnosis is especially enjoyable. The book is generally weak on advanced technology and reproduction of some of the earlier black-and-white glossy plates is of substandard quality.
Assessment: The book provides a wealth of clinical information and experience and is a pleasure to read for its concise, crisp style and historical context. However, recent imaging advances are not included, which detracts from the overall relevance. I would hope that a subsequent edition would rectify this to much greater extent.
3 Stars from Doody
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Meet the Author
William Silen, MD
Johnson and Johnson Professor of Surgery, Emeritus
Harvard University Medical School
Boston, MA
Table of Contents