April 4, 1990

Splanchnic Ischemia and Multiple Organ Failure

Author Affiliations

Harborview Medical Center Seattle, Wash

Harborview Medical Center Seattle, Wash


edited by Adrian Marston, Gregory B. Bulkley, Richard G. Fiddian-Green, et al, 405 pp, with illus, $75, ISBN 0-8016-5523-4, St Louis, Mo, CV Mosby Co, 1989.

JAMA. 1990;263(13):1851. doi:10.1001/jama.1990.03440130149049

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This timely volume focuses the contributions of 37 authors on the role of splanchnic ischemia as both a cause and effect in the development of organ failure following shock and sepsis. Grouped in four sections, "Splanchnic Vascular Anatomy and Physiology," "Pathophysiology," "Splanchnic Organ Injury Syndromes," and "Multiple Organ Failure Syndromes," individual chapters provide concise background to covered topics in a well-organized and generally readable format.

Although the early sections on anatomy and physiology are lengthy for a book of this type, which is in general beyond the interest of those for whom these chapters seem written, the illustrations and photographic reproductions are well done, and the electron and light microscopy of mucosal pathology serve particularly well to highlight the discussion of gastrointestinal barrier breakdown.

Notable are the six chapters on "Systemic Mediators of Splanchnic Origin." These represent an excellent distillation of a complex and often fragmented body of information, interesting