Emergencies in Paediatrics and Neonatology

It may seem unusual for a medical text, ostensibly on child health, to be reviewed in a surgical journal. However, this book covers a number of surgical specialties, with chapters specifically devoted to general surgery, urology, orthopaedics, otolaryngology and trauma. The general surgery section covers intestinal obstruction, pyloric stenosis, intussusception, the acute abdomen, gastrointestinal bleeding and abscess. The orthopaedic section covers limp, infection, joint pain and joint-specific conditions. Both its editors are Australian, although the surgical components have been written by surgeons from Oxford, UK. This book portrays itself as a user-friendly guide to medical emergencies in children that features a structured approach for the early detection of problems. It is symptom-based for easy reference, but like many short texts that cover an enormously wide range of topics, the material often appears as lists, and clinical details that may help distinguish specific conditions are often missing or rudimentary. The brevity has also meant that, at least in the surgical chapters, many topics that might be expected to be covered have not been mentioned. For example, in the section on neck lumps, the only three causes listed are reactive lymph nodes, solitary cysts and malignant lesions. A prominent warning advises that Tb and atypical Tb should not be forgotten, but no information is provided that would allow these conditions to be recognized as such. Management is often presented as lists of items (such as points to remember or investigations to be ordered) with little guidance as to when each may be appropriate or indicated, or how they might be interpreted. For example, investigations listed for urinary tract trauma give no indication of when each might be appropriate. There are a number of omissions, and some common and important conditions get only a brief mention. Sections on ingestion mentioned foreign bodies but not corrosives. Strangulated inguinal hernia occurs as a bullet point in the ‘treatment’ of the painful (acute) scrotum and has no mention in the index – yet this is one of the more common surgical emergencies in children. There are a few inaccuracies such as listing labial fusion as a congenital condition. This book is written primarily for the benefit of the busy paediatric trainee. From a surgical perspective it would be fair to suggest that it has some limitations but is nevertheless a worthy addition to the emergency series published by Oxford University Press.