Atlas of Gastrointestinal Endoscopy and Related Pathology PDF
32.30 MB PDF
In 1986, three of us (KFRS, RC and RH) produced a volume entitled A Colour Atlas of Gastrointestinal Endoscopy which was published under the imprint of Chapman & Hall Medical. Since then there have been many developments in gastroenterology and endoscopy. We therefore felt that the time had come to update and to expand the previous Atlas and also to broaden our approach. With the addition of BFW, the original trio has become a quartet and we have a new title for this second edition, Atlas of Gastrointestinal Endoscopy and Related Pathology. We also have a new publisher, Blackwell Science.
As endoscopy is now universally established we felt that it was inappropriate to include, in an Atlas, any discussion on such topics as the principles of endoscope design, methods of recording visual data, the design of endoscopy rooms or the organization of an endoscopy service. These and other matters, including detailed descriptions of technique and of endoscope sterilization, are covered in other publications, many of which are listed in the section on Bibliography and Other Information.
A fuller discussion of the diseases mentioned, their differential diagnosis and of the various methods of investigation and treatment available is also beyond our remit. We do not dwell in depth on the merits of endoscopy versus classical barium radiology or the newer non-invasive radiological techniques. We do, however, recognize the contribution of endoscopic ultrasonography to clinical practice and a chapter is devoted to this subject.
The place of enteroscopy remains uncertain: it may never become established in all hospitals but is likely to find a permanent niche in reference centres. A chapter on this growing subject has therefore been included.
We could have added a chapter on Growing Points. This might, for example, have included such topics as virtual colonoscopy, endoscopic fluoroscopic spectroscopy, non-visual biosensors, the possible uses of very small robots, and experimental therapeutic techniques such as endoscopic gastroplasty. Every practising endoscopist should be aware of what is new in endoscopy, but we felt that none of these techniques had yet been sufficiently developed to merit further discussion in an Atlas.
Most endoscopists will not regard themselves simply as expert technicians but as members of a gastroenterological team carrying clinical responsibility during endoscopy and also subsequently when major decisions are made on all available evidence, including that from endoscopy. This principle is generally accepted the world over, and for this reason training programmes for gastroenterologists not only set targets for endoscopy but also insist on a working knowledge of gastrointestinal pathology.
To accommodate these developments the most important differences between the original Atlas and the present volume are the inclusion of a chapter on how the pathologist can help the endoscopist, and the presentation of histopathological appearances alongside endoscopic images. No attempt has been made to write a comprehensive textbook of gastrointestinal pathology, but sufficient data are presented to underline the relevance to the endoscopist of some knowledge of pathology. This is reflected in the new title.
The views obtained when using fibre endoscopes and newer video endoscopes are generally similar, as the same regions and lesions are being surveyed. The older images, whether square or round, were often of excellent quality. In the event, most endoscopists now use electronic equipment and are more used to viewing a screen, and recording images on video tape or as video prints. There seemed little point in attempting to replace the better pictures of the original Atlas but we have tried to supplement these as appropriate with images obtained by the use of video endoscopes.
Although this Atlas includes some material from the original work, the text has been almost entirely rewritten and expanded, many images have been replaced and many new ones added, and each chapter has been restructured to suit the new contents and purposes of this venture. While this Atlas is a second edition, we present it to our readers as a new work. It certainly seems so to us, especially taking into account the amount of time and effort expended, we hope to good effect.
For whom is this Atlas intended? As we stated in the Preface to the original Atlas, we aim, firstly, at the less experienced endoscopist so that he or she may gain confidence by having available a range of appearances from which to learn and with which to compare findings. Secondly, more experienced endoscopists may wish to broaden their horizons and may be stimulated by seeing a wider spectrum of appearances than those with which they are familiar. We hope that this Atlas will find a place in the endoscopy room as a bench book, as we are told the previous edition did. Radiologists, pathologists and non-specialist physicians and surgeons may also be interested to examine what the endoscopist actually sees and does during diagnostic and therapeutic procedures. Furthermore, we hope that this publication will lead to a wider understanding of the place of endoscopy in gastroenterology, that it will help decide which patients are most appropriately referred for endoscopy, and not least that it will reveal some of the limitations of the technique. We believe that this new book should be of value to clinical students and their teachers during discussions on gastroenterological topics. With the increasing involvement of interventional radiologists in endoscopic procedures, we wish for them to be among our readers. Histopathologists are also very much a part of the team so it may be of help and interest to them to have a ready access to a collection of endoscopic appearances when handling the fruits of endoscopy. And, last but not least, there is the nurse endoscopist. The number of practitioners in this new specialty has risen rapidly and their breadth of experience has expanded. With increasing acceptance of the new role the number of such specialty nurses will continue to rise. To this new group of potential readers we also extend our welcome and hope that they will find the Atlas useful.
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