Abdominal x rays made easy

James D Begg
Edinburugh: Churchill Livingstone, 1999; £11.99 (paperback)
ISBN: 0443062056

Abdominal x rays made easy - surely an oxymoron, I cynically thought to myself, remembering the humiliation I had suffered during a teaching session on x ray films of said anatomical region.

My preconceptions took a vicious blow as I began to read. An array of fairly obvious, yet surprisingly simple, titles made my introduction to the book less daunting. The book starts with a discussion of normal abdominal x ray films accompanied by well-labelled films, each occupying an entire page. The relevant aspects of each film are discussed in bullet point format on the adjacent pages. This stepwise approach is not skipped over in a hurry to get on to abnormalities; instead it is emphasised by using a number of examples. Each is used to illustrate a point or to teach "moral lessons" better learnt from the book rather than the patient. This system allows the reader to develop a strategy with which to approach each film. This basis is then expanded with respect to individual radiological structures, under headings such as "solid organs" and "hollow organs."

At this point, x ray films with abnormalities are introduced and the salient points shown to the reader. Rather than having to cross reference the radiographic findings with another textbook, readers will find that, helpfully, the aetiologies are listed on the subsequent pages.

Once the various intra-abdominal organs have been worked through, and with even the least intrepid reader wooed, pathologies are introduced. The potential morass of pathology is subdivided neatly into areas with attractive and self explanatory titles such as abdominal gas, ascites, and abnormal intra-abdominal calcification. In these chapters, the author never strays from his carefully chosen formula, still giving differential diagnoses. These he augments with advice on mistakes not to be made, either to avoid embarrassment or, much more importantly, to prevent missing life threatening diagnoses.

The final chapters deal with trauma, iatrogenic objects, and misleading images, probably more use for house officers, or those abnormalities found only in exams that are dreaded by examiner and examinee.

Although I had sat down with a heavy heart at the seemingly insurmountable task of interpretation ahead, I was surprised to find myself actually enjoying the book. I emerged at the end far better informed and much more confident.

Iain McNamara, final year medical student, Magdalen College, University of Oxford


studentBMJ 2000;08:175-216 June ISSN 0966-6494