Liver disease in kids | |
Diseases of the liver and biliary system in children. Deirdre A Kelly, editor. Oxford: Blackwell Science 1999 (xvii + 375pp.). ISBN: 0 632 04802 6. |
Diseases of the liver
and biliary system in children is an updated view of the full spectrum of paediatric hepatology, from neonatal jaundice to liver and small bowel transplantation. Dr Deirdre A Kelly is a paediatric hepatologist with the liver unit in Birmingham, UK, and is eminently qualified to bring together the team of predominantly, but not exclusively, British authors who have contributed the different chapters. The text adopts a problem-based approach that reflects the clinical experience of the chapter authors. In conjunction with this approach are a series of simple-to-follow algorithms which summarise up-to-date diagnostic and management approaches to the different clinical problems discussed. For instance, the algorithm dealing with the acutely ill infant nicely summarises the steps in the metabolic diagnosis of infantile liver disease, reducing a complex picture into a simple decision tree. A frustrating aspect of the text is the variable depth of coverage. Neonatal unconjugated jaundice, probably the commonest childhood liver problem encountered by paediatricians (albeit infrequently by hepatologists), is covered in three pages, while primary hepatic tumours receive 12 pages and disorders of copper metabolism 19 pages. The latter two chapters provide excellent reviews of their topics, as do the chapters on transplantation and the management of chronic liver disease. The highpoint of the book is an atlas of clinical and diagnostic imaging pictures and histology plates. These are all of extremely high quality and this alone will make the text attractive to trainees in paediatrics and paediatric hepatology. This text will prove useful to generalists who deal intermittently with children with liver disease, representing a starting point for guidance on diagnosis, management and discussion with parents. It will also be popular with trainees who need an overview of many of the less common childhood liver diseases and their treatment. Its strengths are that it is generally up-to-date, is easy to read and is complemented by easy-to-follow algorithms and the atlas of colour plates. Its major weaknesses are the patchy treatment of different problems, so that it is unlikely to become a reference for paediatric hepatologists, and its cost. David A Forbes
|