This famous text is much beloved by medical students and physicians-in-training throughout the English-speaking world, as its many editions indicate. Despite its relatively narrow focus, it is chock full of the pearls of clinical wisdom that students and practitioners treasure, and many of these lessons apply to medicine in general. The book was well characterized by a reviewer of an earlier edition for The New England Journal of Medicine: "If only one book about surgery could be made available to physicians from all specialties, it should probably be Silen's recent revision of Cope's Early Diagnosis of the Acute Abdomen. Since the book first appeared more than 30 years ago, it has remained the classic treatise on the initial approach to abdominal pain." Because acute, severe abdominal pain is still a common problem whose misdiagnosis can result in quick death, each generation of beginning physicians is faced with the urgency of learning to make a diagnosis in this high anxiety situation and they appreciate the wise, humane, precisely detailed guidance offered by Cope and Silen. For the 21st Edition, Dr. Silen has again updated the text in a respectful but significant way. He has strengthened its emphasis on pitfalls in the interpretation of CT and ultrasound scans, on misadventures caused by over-reliance on blood tests and radiographs, and on careful history-taking to avoid the costs of inappropriate lab tests. He has also reviewed the data from a randomized clinical trial indicating that patients should receive adequate analgesia while awaiting a definitive diagnosis, a dictum that is contrary to traditional teaching.

1. The principles of diagnosis in acute abdomen disease 2. Methods of diagnosis: The history 3. Methods of diagnosis: The examination of the patient 4. Methods of diagnosis: The grouping of systems and signs 5. Laboratory and radiological tests 6. Appendicitis 7. The differential diagnosis of appendicitis 8. Perforation of a gastric or duodenal ulcer 9. Acute pancreatitus 10. Cholecystitis and other causes of acute pain in the right upper quandrant of the abdomen 11. Acute abdominal lesions arising in the left hypochondrium 12. The colics 13. Acute intestinal obstruction 14. Intussusception and other causes of obstruction 15. The early diagnosis of strangulated and obstructed hernias 16. Acute abdominal symptoms due to vascular lesions 17. Acute abdominal symptoms in women 18. Early ectopic gestation 19. Acute abdominal disease with genitourinary symptoms 20. The diagnosis of acute peritonitis 21. The early diagnosis of abdominal injuries 22. The postoperative abdomen 23. The acute abdomen in the tropics 24. Diseases that may stimulate the acute abdomen 25. Acute abdominal pain in the immunocompromised patient 26. Abdominal catastrophes when sensation is impaired

"The book provides a wealth of clinical information and experience and is a pleasure to read for its concise, crisp style and historical context."--Doody's Book Review Service