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Handbook of Pediatric Autopsy Pathology, 1stEdition, by Enid Gilbert-Barness and Diane E. Debich-Spicer, Hardback, acid-free Paper, 11.3” x 8” x 1.2” [Comes with a CD]
Springer, [imprint - Humana], 233 Spring Street, New York, NY 10013, USA
; Publication Date: 28 January 2005. xiv + 531 pages, ISBN-10: 158829224X, ISBN-13: 978-1588292247, E-ISBN 1-59259-673-8. Price $225.00.
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"Handbook of Pediatric Autopsy Pathology" is a book written to “fill a current void in the armamentarium for the pathologist performing the pediatric autopsy”. Such is the claim of the authors in the preface. There is no doubt that a void exists in the books on this topic. But whether this book is able to fill that void is something we are going to see. And the best way of doing that (according to us) is to compare it with the present gold standard in performing the adult autopsy i.e. “Handbook Of Autopsy Practice” by Jurgen Ludwig. To do that we kept both the books side by side and went through both of them simultaneously so that we could compare each and every aspect of both the books.
The first point of difference between the two books is in the photographs. While the number and quality of photographs is almost same in both the books, both being in black and white, what scores in the present book is the inclusion of the companion CD. This CD contains color versions of most of the photographs that have been included in the text. This seems to have served a couple of purposes. Since the color photographs are present on the CD, they were not required to be printed in the book, thereby reducing the cost of the book. Secondly, by including these photographs in the CD, the photographs can be enlarged on the computer to visualize minor details, if required. This is not possible in the photographs that are printed in the text. These are a couple of major advantages that this book has over most other books.
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The first section of the book deals with general principles. In this section the authors have mentioned about the various definitions like the manners of death, deaths that must be referred to the medical examiner, the benefits of autopsy etc. Instead of running pages explaining these things the authors have done a good thing by just enumerating the salient features of each of the aspects that they have touched upon in this chapter. That saves both time and energy in going through them. But there were some aspects that, if described in a more exhaustive way, would have made the book even more appealing. Some of these are like mentioning the differences between the mode, manner and cause of death and mentioning the laws relating to the donation of dead bodies in some other countries also in addition to United States. That would have given the reader some idea about the various laws that are prevelant in various parts of the world.
 ...The second section deals with autopsy techniques. The authors have divided it into three chapters, viz. pediatric autopsy, embryonic autopsy (called examination of the human embryo) and placenta. These three chapters are in essence the backbone of the book since the basic aim of the book is to tell about the methods of doing pediatric autopsy... |
The second section deals with autopsy techniques. The authors have divided it into three chapters, viz. pediatric autopsy, embryonic autopsy (called examination of the human embryo) and placenta. These three chapters are in essence the backbone of the book since the basic aim of the book is to tell about the methods of doing pediatric autopsy. And the authors do not disappoint in this regard. It is in fact a job pretty well accomplished. They have described the methods of dissection of various organs and organ systems quite effectively. The presence of adequate number of good quality photographs, both in black and white and color (in the companion CD), make the reading a pleasurable exercise and go a long way in helping to understand the various techniques that have been described. There is a phrase in Hindi that says “sone pe suhaga” which means that something very good is made even better by adding something to it. The same goes for the appendices at the end of each of the three chapters. These appendices provide more information than is usually expected in the books of this nature. In addition to the normal weights at various ages which is routinely present in almost all books, the authors have provided with an autopsy checklist, protocol for gross examination of the brain, regional development of cerebral hemispheres, gyri pattern of brain etc. that significantly increase the usability of the book. They might appear small things for the uninitiated, but a seasoned pathologist knows their importance, especially if he has spent hours trying to find the references where he can find these data. The same goes for the other two chapters in this section where the authors have pictorically described the stages of human embryonic development. Without going through lengthy texts, they provide the proper and adequate knowledge that is required by the pathologist. Not just the appendices, the photographs and line diagrams, as also the tables, that have been provided in these chapters have been chosen and included at the right places so that the reader doesn’t has to flip pages repeatedly to search for the required information.
...Without going through lengthy texts, they provide the proper and adequate knowledge that is required by the pathologist. Not just the appendices, the photographs and line diagrams, as also the tables, that have been provided in these chapters have been chosen and included at the right places so that the reader doesn’t has to flip pages repeatedly to search for the required information... |
Another aspect that needs to be mentioned is that the authors have described the various techniques of dissection even in the relevant chapters later in the book. What it does is that it gives the basic overview in this section and specialized techniques relevant to a particular system or pathology is described in the chapter dedicated to that organ system. This is what we call the proper organization where everything is present where it should be. In short, these are the chapters that deserve just one word for their description – EXCELLENT.
The next two sections viz. part III and part IV deal with individual disorders, part III with developmental disorders and part IV with organ systems and metabolic disorders. In these two sections, the authors take one disease at a time and then describe it in detail, including its pathology and clinical features. An important thing that is visible in these sections is that the authors have described only those things that are relevant and in the detail that is required. For example while the disorders of cardiovascular system have been given a lot of space and importance, the metabolic disorders like the various glycogenosis or some ophthalmologic conditions have been described in only single paragraph each. This shows that the authors have a good grasp over the subject and have included only the relevant details. This makes the reading a pleasurable experience as the reader is not bombarded with unnecessary and useless information that might bore him and make him repent his decision to have wasted money on unnecessary information.
...It is appropriate here to mention about the tables that have been included in the book. Whether they are present in the main text or appendix, they provide a lot of information in a small space that help in quick review, especially when one is conducting an autopsy... |
It is appropriate here to mention about the tables that have been included in the book. Whether they are present in the main text or appendix, they provide a lot of information in a small space that help in quick review, especially when one is conducting an autopsy. Be it the incidence of chromosomal anomalies, the various abnormalities seen in different chromosomal defects, classification of cardiovascular defects, autopsy checklist of congenital heart disease, syndromes associated with gastrointestinal anomalies or genito-urinary abnormalities, neural tube closure defects, so on and so forth, these tables go a long way in providing information in a concise form that is easy to use and understand. Also requiring mention here is the inclusion of McKusick no in most of the tables that describe congenital anomalies. It helps in correlating the disorder with the number when required.
The last section i.e. part V deals with special considerations. In this section there are four chapters viz. “sudden infant death”, “pediatric forensic pathology”, “special procedures” and “infection control and biological hazards in the autopsy”. Whatever we have mentioned earlier about the rest of the book goes for this section too. We had mentioned earlier that the authors have not mentioned about the differences between cause, mode and manner of death. They have done so in this section in the chapter “pediatric forensic pathology”. But here also these terms have not been given the importance that they deserve. So we would suggest that in the next edition this omission would be corrected.
...While the present book is written in the form of a textbook by describing each disease entity, the book by Jurgen Ludwig, on the other hand, has been written in a different format... |
The first major error that we found in the book was on page 478. Here in the section on identification of the body, the first paragraph describes the methods that can be used for identification. The second and third paragraphs describe the role of potassium ion concentration in finding time since death (postmortem interval). The next paragraph describes the rate of decomposition of the bodies in air, water and after burial. And finally the last paragraph, which is just a single line, states “cyanide reacts chemically with formaldehyde t the extent that it can no longer be identified”. We were simply unable to understand what is the point of this heading and what exactly the authors want to depict in this section. By looking at it, one feels that it is a gross error in proof reading, as the various paragraphs intended for different sections have been merged together. But whatever be the reason for this mistake, it has to be corrected.
There is another irritant in the book. That is regarding the references. While the list of references given at the end of each chapter is pretty exhaustive, they are not numbered or indicated in any way in the text. That creates a big problem when one encounters something in the book and wants to either cross check the reference or go through the original manuscript. In either case, it becomes very difficult to find out which is the original article. So the references have to be properly cross-referenced in the text also to make cross checking easier for the reader.
...we can conclude that the book “Handbook of Pediatric Autopsy Pathology” is going to be a benchmark for any future material that is written on pediatric autopsy. This book will not only be an asset with any pathologist who deals with pediatric cases, but would also prove to be a handy reference for other clinicians whenever they are searching for something related to pediatric autopsy... |
Having discussed the relative merits and demerits of this book, let us now see how it fares with respect to the one with which we had decided to compare it at the outset. We have already mentioned about the presence of colored photographs in the present book. The other major aspect is the organization of the book. While the present book is written in the form of a textbook by describing each disease entity, the book by Jurgen Ludwig, on the other hand, has been written in a different format. There the author has mentioned all the disease entities alphabetically, in a tabular form, describing the important (expected) findings in various organ systems and the tissues/organs that have to be preserved. Personally we found the latter approach more handy and easy to use, and also being more complete than the former one. The reason for this preference is that since the book is not a textbook of pathology, one is never going to provide an exhaustive list and description of all the disease entities. But by putting it in the tabular form and providing the important findings, it becomes easier to incorporate much larger number of diseases. Since one can always refer a specialized textbook in pathology for detailed description of the disease, providing more number of conditions with major findings is more relevant in a book of this nature.
As we have seen, there is not much difference between the two books as far as the content or organization goes. While one book has advantage in one aspect, the other scores in the other aspect. By that yardstick, if one book is a gold standard in its specialty, the other, quite naturally, becomes a milestone in its specialty. Therefore we can conclude that the book “Handbook of Pediatric Autopsy Pathology” is going to be a benchmark for any future material that is written on pediatric autopsy. This book will not only be an asset with any pathologist who deals with pediatric cases, but would also prove to be a handy reference for other clinicians whenever they are searching for something related to pediatric autopsy. And as far as the students go, it is a complete necessity without which their knowledge of pediatric pathology and procedures of doing pediatric autopsy will always remain deficient. In other words, no pathologist can afford to have this book missing from his cabinet/bookshelf. A NECESSITY FOR EVERY PATHOLOGIST.
-Puneet Setia
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Dr. Puneet Setia is working as a Senior Resident doctor in the department of Forensic Medicine and Toxicology at All India Institute of Medical Sciences (AIIMS), New Delhi. His research interests include Forensic Radiology, especially the use of radiology in demonstrating coronary narrowing at the post-mortem examination. He is associated with Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology as a writer and book reviewer. He can be contacted at