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Book Review

Indian Pediatrics 2000;37: 1037

Diseases of the Liver and Biliary System in Children.

Author: Deirdre A. Kelly, Blackwell Science Ltd., Oxford, 1999, Pages 392, usual price £ 99.50; special  Indian Price Rs 1103/- Distributed by Jaypee Brothers Medical Publishers, 23/23B EMCA House, Ansari  Road, Daryaganj, New Delhi 110021.

Pediatric Hepatology has established itself during the last decade as a distinct speciality within pediatrics and pediatric gastroenterology, considering the peculiarities of diseases of liver and biliary system in children. This book has been published at a time when the students as well as teachers in Pediatric Hepatology are looking forward to sharing global experiences in this field and to focus on certain clinical problems so commonly encountered in their day to day practice. The contents of the book cover a wide spectrum of topics ranging from genetic disturbances of bilirubin and bile salt transport in the neonates to psychology of parents of children on transplantation waiting lists. Authors have been carefully chosen and they in turn have written their respective chapters lucidly from their personal experience. The highlight of the book includes a number of useful algorithms and provides a practical approach to pediatric liver disease.

The Chapter on useful investigations gives clear guidelines for baseline investigations, second line investigations and other multi-disciplinary investigations involving endoscopy, radiology, histopathology, immunochemistry, etc. The Chapter titled ‘The Jaundiced Baby’ addresses the critical issues faced by Pediatricians and Neonatologists and offers a practical insight into neonatal liver disease with all its diversities ranging from breast milk jaundice to various surgical emergencies related to liver and biliary system.

Information on hepatitis has been updated and non-viral hepatitis and liver abscesses have been given due importance. The Chapter on Fulminant Hepatitis has been nicely written with simple management algorithm. Disorders of copper metabolism also include Indian Childhood Cirrhosis (ICC) with very concise and updated picture regarding its etiology and epidemiology. ICC like disorders have been discussed highlighting the epidemiological triad related to copper metabolism manifesting variously under different epidemiological conditions. Role of genetic factors in copper intoxication syndromes supplements the current concepts regarding these disorders. Pediatricians as well as dentists will find the chapter on ‘Altered drug and protein metabolism in children with chronic liver diseases for liver grafts’ interesting. Effect on enamel of their teeth, delayed eruptions of primary dentition, dental staining/caries and gingival overgrowth as a consequence of liver disease and liver transplantation provides another perspective of these problems. The Chapter on liver and intestinal transplantation gives a comprehensive account of indications, timing for transplantation, pre and post transplant evaluation and follow up which is strengthened by editor’s personal experience in the field.

The academic quality of the book is enhanced by a collection of 75 carefully annotated photographs which gives a visual account of the well known as well as not so well known problems. The book fills a real gap in our knowledge of liver disease and is a timely addition of a reference material which will certainly be useful for postgraduate students as well as practicing Pediatric Hepatologists.

A.K. Patwari
Professor of Pediatrics,
Lady Hardinge Medical College and
Associated Kalawati Saran Children’s Hospital,
New Delhi- 110 001, India.


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