This renowned text is cherished by medical students and physicians-in-training across the English-speaking world, as reflected in its numerous editions. Although its focus is relatively narrow, it is filled with invaluable clinical wisdom that resonates with students and practitioners alike, many of whom find its lessons applicable to the broader field of medicine. A reviewer for The New England Journal of Medicine aptly noted that if only one book on surgery could be made available to physicians from all specialties, it should be this one. Since its inception over 30 years ago, it has remained the definitive guide on addressing abdominal pain. Given that acute, severe abdominal pain is a prevalent issue whose misdiagnosis can lead to dire consequences, each new generation of physicians must learn to diagnose effectively in these high-stakes situations. They benefit from the wise, humane, and meticulously detailed guidance provided. In the 21st Edition, Dr. Silen has made significant updates, enhancing the focus on pitfalls in interpreting CT and ultrasound scans, the dangers of over-relying on blood tests and radiographs, and the importance of thorough history-taking to prevent unnecessary lab tests. He has also reviewed data from a randomized clinical trial advocating for adequate analgesia while patients await a definitive diagnosis, challenging traditional teachings.
