Sleisenger e Fordtran - Malattie gastrointestinali ed epatiche Fisiopatologia, diagnosi e trattamento
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Mark Feldman
Lawrence S. Friedman
Lawrence J. Brandt
1
Sleisenger e Fordtran
Malattie gastrointestinali
ed epatiche
Fisiopatologia, diagnosi e trattamento
DECIMA EDIZIONE
A cura di
AMENTO
DIN NA
OR
ZI
CO
ON
GIA - 1993 -
ALE DEI DOC
LO
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ID TE
I GASTROEN
Coordinamento
nazionale
dei docenti
di gastroenterologiaTitolo originale dell’opera: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 10th Edition © 2016 by Elsevier, Inc. All rights reserved. Copyright © 2010, 2006, 2002, 1998, 1993, 1989, 1983, 1978, 1973 by Elsevier. ISBN: 978-1-4557-4692-7 This translation Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 10th Edition by Mark Feld- man, Lawrence S. Friedman and Lawrence J. Brandt is published by arrangement with Elsevier, Inc. Questa traduzione del volume Sleisenger and Fordtran’s Gastrointestinal and Liver Disease, 10th Edi- tion di Mark Feldman, Lawrence S. Friedman and Lawrence J. Brandt è pubblicata in accordo con Elsevier, Inc. Traduzione dalla lingua inglese, per conto di Edra S.p.A., a cura di: Editrice Gastroenterologica Italiana S.r.l. Responsabile Editoriale Libri: Costanza Smeraldi Responsabile Redazione Libri: Matteo Brambilla Responsabile Produzione Libri: Michele Ribatti Redazione e impaginazione: F.lli Sala snc, Seregno (MB) © 2018 Edra S.p.A.* – Tutti i diritti riservati ISBN: 978-88-214-4404-3 eISBN: 978-88-214-4405-0 I diritti di traduzione, di memorizzazione elettronica, di riproduzione e adattamento totale o parziale con qualsiasi mezzo (compresi i microfilm e le copie fotostatiche), sono riservati per tutti i Paesi. Le fotocopie per uso personale del lettore possono essere effettuate nei limiti del 15% di ciascun volume dietro pa- gamento alla SIAE del compenso previsto dall’art. 68, commi 4 e 5, della legge 22 aprile 1941 n. 633. Le fotocopie effettuate per finalità di carattere professionale, economico o commerciale o comunque per uso diverso da quello personale possono essere effettuate a seguito di specifica autorizzazione rilasciata da CLEARedi, Centro Licenze e Autorizzazioni per le Riproduzioni Editoriali, Corso di Porta Romana 108, 20122 Milano, e-mail autorizzazioni@clearedi.org e sito web www.clearedi.org. La traduzione è stata effettuata da Edra S.p.A sotto la propria responsabilità. Medici e ricercatori devono sempre fare affidamento sulla loro esperienza e sulle loro conoscenze nella valutazione e nell’utilizzo di qualsiasi informazione, metodo, prodotto o esperimento descritti nel presente volume. A causa dei rapidi progressi delle scienze mediche, in particolare dovrebbe essere effettuata una verifica indipendente delle diagnosi e dei dosaggi dei farmaci. Nella misura massima consentita della legge, Elsevier, Autori, redattori e collaboratori non si assumono responsabilità in relazione alla traduzione, per lesioni o danni a persone o cose, negligenza o qualsiasi altro utilizzo di metodi, prodotti, istruzioni o idee contenuti nel presente volume. Edra S.p.A. Via G. Spadolini 7, 20141 Milano Tel. 02 881841 www.edizioniedra.it Printed in Italy Finito di stampare nel mese di marzo 2018 presso “Printer Trento” S.r.l., Trento (*) Edra S.p.A. fa parte di
Autori
Abier Abdelnaby, MD Olga C. Aroniadis, MD John T. Bassett, MD
Associate Professor of Surgery Senior Fellow, Gastroenterology Deputy Chief Gastroenterology
University of Texas Southwestern Medical Albert Einstein College of Medicine Internal Medicine
Center 0RQWHÀRUH0HGLFDO&HQWHU Walter Reed National Military Medical
Dallas, Texas Bronx, New York Center
Bethesda, Maryland
Julian A. Abrams, MD Fernando Azpiroz, Prof, MD, PhD
Assistant Professor of Medicine, Department Professor of Medicine Anne E. Becker, MD, PhD
of Medicine Universitat Autonoma de Barcelona Maude and Lillian Presley Professor of
Columbia University College of Physicians Chief, Gastroenterology Department Global Health and Social Medicine
and Surgeons Univerisyt Hopsital Vall d’Hebron Department of Global Health and Social
New York, New York Centro de Investigacion Biomedica en Red Medicine
de Enfermedades Hepaticas y Digestivas Harvard Medical School
(Ciberehd) Associate Professor of Psychiatry,
Nada A. Abumrad, PhD Barcelona, Spain Department of Psychiatry
Department of Medicine Massachusetts General Hospital
Center for Human Nutrition Boston, Massachusetts
Washington University Bruce R. Bacon, MD
St. Louis, Missouri James F. King MD Endowed Chair in
Gastroenterology, Professor of Internal Alex S. Befeler, MD
Medicine Professor of Internal Medicine
Nezam H. Afdhal, MD Division of Gastroenterology and Medical Director Liver Transplantation
Professor of Medicine Hepatology Division of Gastroenterology and
Harvard Medical School Saint Louis University School of Medicine, Hepatology
Division of Gastroenterology St. Louis, Missouri Saint Louis University
Liver Center St. Louis, Missouri
Beth Israel Deaconess Medical Center
Boston, Massachusetts William F. Balistreri, MD
Director, Pediatric Liver Care Center Taft P. Bhuket, MD
Gastroenterology, Hepatology, and Nutrition Assistant Clinical Professor of Medicine,
Rakesh Aggarwal, MD, DM Children’s Hospital Medical Center Division of Gastoenterology
Professor, Gastroenterology Cincinnati, Ohio University of California, San Francisco
Sanjay Gandhi Postgraduate Institute of San Francisco, California
Medical Sciences Chief of Gastroenterology
Lucknow, India Todd H. Baron, MD Director of Endoscopy
Professor of Medicine &KLHIRI6WDͿ
Director of Advanced Therapeutic Alameda Health System
Karin L. Andersson, MD Endoscopy
Hepatologist Oakland, California
Division of Gastroenterology and
Gastrointestinal Unit Hepatology
Massachusetts General Hospital University of North Carolina L. Ashley Blackshaw, PhD
Instructor in Medicine School of Medicine Professor of Enteric Neuroscience
Harvard Medical School Chapel Hill, North Carolina Blizard Institute
Boston, Massachusetts Queen Mary University of London
London, United Kingdom
Bradley A. Barth, MD
Jane M. Andrews, MBBS, PhD Associate Professor, Pediatrics
Clinical Associate Professor University of Texas Southwestern Medical Boris Blechacz, MD, PhD
Head IBD Service and Education Center Assistant Professor of Medicine,
Department of Gastroenterology and Dallas, Texas Gastroenterology, Hepatology, and
Hepatology Nutrition
Royal Adelaide Hospital and University of MD Anderson Cancer Center
Adelaide Lee M. Bass, MD Houston, Texas
Adelaide, Australia Assistant Professor of Pediatrics
Gastroenterology, Hepatology and Nutrition
Ann and Robert H. Lurie Children’s Diego V. Bohórquez, PhD
Farshid Araghizadeh, MD Hospital of Chicago Postdoctoral Fellow
Professor of Surgery Northwestern University Feinberg School of Department of Medicine
Department of Surgery Medicine Duke University Medical Center
Chief, Section of Colon and Rectal Surgery Chicago, Illinois Durham, North Carolina
University of Texas Southwestern Medical
Center
Dallas, Texas
viiviii Autori
Lawrence J. Brandt, MD Andres F. Carrion, MD Albert J. Czaja, MD
Professor of Medicine and Surgery Division of Hepatology Professor Emeritus of Medicine
Albert Einstein College of Medicine University of Miami Miller School of Gastroenterology and Hepatology
Emeritus Chief Medicine Mayo Clinic College of Medicine
Division of Gastroenterology Miami, Florida Rochester, Minnesota
0RQWHÀRUH0HGLFDO&HQWHU
Bronx, New York
Scott Celinski, MD Brian G. Czito, MD
Division of Surgical Oncology Associate Professor
George A. Bray, MD Baylor University Medical Center Radiation Oncology
Boyd Professor Dallas, Texas Duke University Medical Center
Clinical Research Durham, North Carolina
Pennington Biomedical Research Center
Louisiana State University
Francis K.L. Chan, MD, DSc
Baton Rouge, Louisiana Professor of Medicine Paul A. Dawson, PhD
Institute of Digestive Disease Professor
Chinese University of Hong Kong Division of Pediatric Gastroenterology,
Robert S. Bresalier, MD Hong Kong, China Hepatology, and Nutrition
Professor of Medicine Emory University School of Medicine
Lydia and Birdie J. Resoft Distinguished Atlanta, Georgia
Professor in Gastrointestinal Oncology
Shivakumar Chitturi, MD
Gastroenterology, Hepatology, and Nutrition 6WDͿ6SHFLDOLVW
The University of Texas MD Anderson Gastroenterology and Hepatology Unit Gregory de Prisco, MD
Cancer Center, Canberra Hospital Director of Emergency Radiology
Houston, Texas Garran, Australia Baylor University Medical Center
Dallas, Texas
Stuart M. Brierley, PhD Daniel C. Chung, MD
NHMRC R.D. Wright Biomedical Fellow; Associate Professor of Medicine Kenneth R. DeVault, MD
Discipline of Physiology, Faculty of Health Harvard Medical School Professor and Chair of Medicine
Sciences Director, GI Cancer Genetics Program Mayo Clinic
Discipline of Medicine, Faculty of Health GI Unit and Cancer Center Jacksonville, Florida
Sciences Massachusetts General Hospital
The University of Adelaide Boston, Massachusetts
Adrian M. Di Bisceglie, MD
Department of Gastroenterology and Badeeh A. and Catherine V. Bander Chair in
Hepatology Raymond T. Chung, MD Internal Medicine
Royal Adelaide Hospital Director of Hepatology, Vice Chief, Chairman and Professor of Internal Medicine
Adelaide, Australia Gastroenterology Chief of Hepatology
Massachusetts General Hospital Saint Louis University
Robert S. Britton, PhD Boston, Massachusetts St. Louis, Missouri
Adjunct Associate Research Professor
Department of Internal Medicine, Division of Robert H. Collins, Jr., MD Philip G. Dinning, PhD
Gastroenterology and Hepatology Director, Hematologic Malignancies/Blood Associate Professor
Saint Louis University School of Medicine and Marrow Transplantation Program Senior Medical Scientist
St. Louis, Missouri Professor of Internal Medicine Flinders University
University of Texas Southwestern Medical Departments of Gastroenterology
Simon J.H. Brookes, PhD Center and Surgery
Professor of Human Physiology Dallas, Texas Flinders Medical Center
Flinders Medical Science and Technology, Adelaide, Australia
School of Medicine Marcello Costa, MD
Flinders University Matthew Flinders Distinguished Professor Iris Dotan, MD
Adelaide, Australia and Professor of Neurophysiology Sackler Faculty of Medicine
Physiology Tel Aviv University
Alan L. Buchman, MD, MSPH Flinders University Head, IBD Center
Professor of Medicine and Surgery Adelaide, Australia Gastroenterology and Liver Diseases
Medical Director of Intestinal Rehabilitation/ Tel Aviv Sourasky Medical Center
Transplant Center Tel Aviv, Israel
Diane W. Cox, PhD
Division of Gastroenterology Professor of Medical Genetics
Northwestern University Feinberg School of University of Alberta J. Marcus Downs, MD
Medicine Faculty of Medicine Program Director
Chicago, Illinois Edmonton, Alberta, Canada Colon and Rectal Surgery
Parkland and Presbyterian Hospitals
Robert L. Carithers, Jr., MD Sheila E. Crowe, MD Dallas, Texas
Professor of Medicine Professor of Medicine
University of Washington Division of Gastroenterology Douglas A. Drossman, MD
Director, Liver Care Line Department of Medicine Professor Emeritus of Medicine and
University of Washington Medical Center University of California, San Diego Psychiatry
Seattle, Washington San Diego, California Center for Functional GI and Motility
Disorders
University of North Carolina
President
Center for Education and Practice of
Biopsychosocial Care
Chapel Hill, North CarolinaAutori ix
Kerry B. Dunbar, MD, PhD Geoffrey C. Farrell, MD Chris E. Forsmark, MD
Assistant Professor of Medicine Professor of Hepatic Medicine Professor of Medicine
Department of Medicine—Division of Australian National University University of Florida College of Medicine
Gastroenterology and Hepatology 6HQLRU6WDͿ+HSDWRORJLVW Gainesville, Florida
University of Texas Southwestern Medical The Canberra Hospital
School Woden, Australia
6WDͿ3K\VLFLDQ
Amy E. Foxx-Orenstein, DO
Department of Medicine—Gastroenterology Professor of Medicine
Section
Jordan J. Feld, MD Mayo Clinic
VA North Texas Healthcare System—Dallas Assistant Professor of Medicine Scottsdale, Arizona
VA Medical Center Toronto Western Hospital Liver Centre
Dallas, Texas Scientist
Sandra Rotman Centre for Global Health
Frank K. Friedenberg, MD
University of Toronto Professor of Medicine
John E. Eaton, MD Toronto, Ontario, Canada Gastroenterology
Instructor of Medicine Temple University School of Medicine
Department of Internal Medicine Philadelphia, Pennsylvania
Division of Gastroenterology and
Marc D. Feldman, MD
Hepatology Clinical Professor
Department of Psychiatry
Lawrence S. Friedman, MD
Mayo Clinic Professor of Medicine
Rochester, Minnesota Adjunct Professor
Department of Psychology Harvard Medical School
University of Alabama Professor of Medicine
Ellen C. Ebert, MD Tuscaloosa, Alabama Tufts University School of Medicine
Professor of Medicine Boston, Massachusetts
University of Medicine and Dentistry The Anton R. Fried, MD, Chair
of New Jersey
Mark Feldman, MD Department of Medicine
New Brunswick, New Jersey William O. Tschumy, Jr., MD, Chair Newton-Wellesley Hospital
of Internal Medicine Newton, Massachusetts
Director, Internal Medicine Residency Assistant Chief of Medicine
David E. Elliott, MD, PhD Program Massachusetts General Hospital
Department of Internal Medicine Texas Health Presbyterian Hospital Dallas Boston, Massachusetts
Carver College of Medicine Clinical Professor of Internal Medicine
University of Iowa University of Texas Southwestern Medical
Department of Internal Medicine School
Manish K. Gala, MD
Veterans Administrattion Health Care Dallas, Texas Research Fellow in Medicine
System Harvard Medical School
Iowa City, Iowa Clinical and Research Fellow
Lincoln Eduardo Ferreira, MD, PhD Gastrointestinal Unit
Director of Digestive Endoscopy Unit Massachusetts General Hospital
B. Joseph Elmunzer, MD Gastrointestinal and Hepatology Boston, Massachusetts
Division of Gastroenterology Hospital Universitario of UFJF
University of Michigan Medical School Hosptial Monte Sinai
Ann Arbor, Michigan Juiz de For A
Robert E. Glasgow, MD
Minas Gerais, Brazil Associate Professor
Section Chief
Grace H. Elta, MD Gastrointestinal and General Surgery
Division of Gastroenterology Paul Feuerstadt, MD Vice Chairman
University of Michigan Medical School Clinical Instructor Clinical Operations and Quality
Ann Arbor, Michigan Yale University School of Medicine Department of Surgery
Yale-New Haven Hospital University of Utah
New Haven, Connecticut Salt Lake City, Utah
Silvia Degli Esposti, MD
Associate Professor of Medicine
Director of Fellowship Pathway in Women’s Laurel Fisher, MD Gregory J. Gores, MD
Gastrointestinal Diseases Associate Professor Executive Dean for Research
Warren Alpert Medical School of Brown Division of Gastroenterology Professor of Medicine
University Department of Internal Medicine Division of Gastroenterology and
Director University of Michigan Medical School Hepatology
Center for Women’s Gastrointestinal Ann Arbor, Michigan Mayo Clinic
Medicine Rochester, Minnesota
Women’s Medicine Collaborative
Miriam Hospital
Alexander C. Ford, MD
Providence, Rhode Island Associate Professor and Honorary Norton J. Greenberger, MD
Consultant Gastroenterologist Clinical Professor of Medicine
Leeds Gastroenterology Institute Harvard Medical School
Michael B. Fallon, MD St. James’s University Hospital Senior Physician
Professor of Medicine Leeds, West Yorkshire, United Kingdom Brigham and Women’s Hospital
Gastroenterology, Hepatology and Nutrition Boston, Massachusetts
The University of Texas Health Science
Center at Houston
John S. Fordtran, MD
Houston, Texas Internal Medicine
Division of Gastroenterology
Baylor University Medical Center
Dallas, Texasx Autori
David A. Greenwald, MD Christoph Högenauer, MD David A. Katzka, MD
Professor of Clinical Medicine Associate Professor of Medicine Professor of and Consultant in Medicine
Albert Einstein College of Medicine Department of Internal Medicine Mayo Clinic
Associate Division Director Medical University of Graz Rochester, Minnesota
Gastroenterology Fellowship Program Graz, Austria
Director
Division of Gastroenterology and Liver
Debra K. Katzman, MD
Diseases
Sohail Z. Husain, MD Professor of Pediatrics
Albert Einstein College of Medicine/ Associate Professor of Pediatrics Senior Associate Scientist
0RQWHÀRUH0HGLFDO&HQWHU University of Pittsburgh and the Children’s Research Institute
Bronx, New York Hospital of Pittsuburgh Division of Adolescent Medicine
of UPMC Department of Pediatrics
Pittsburgh, Pennsylvania The Hospital for Sick Children
Evan B. Grossman, MD University of Toronto
Assistant Professor of Medicine Toronto, Ontario, Canada
Division of Gastroenterology and
Christopher D. Huston, MD
Hepatology Associate Professor
SUNY Downstate Medical Center Departments of Medicine, Microbiology, and Jonathan D. Kaunitz, MD
Brooklyn, New York Molecular Genetics Professor
University of Vermont College of Medicine Medicine and Surgery
Attending Physician University of California, Los Angeles
Yael Haberman, MD, PhD Medicine and Infectious Diseases School of Medicine
Fellow Fletcher Allen Health Care 6WDͿ3K\VLFLDQ
Pediatric Gastroenterology, Hepatology, and Burlington, Vermont Medicine
Nutrition :HVW/RV$QJHOHV9HWHUDQV$ͿDLUV0HGLFDO
Cincinnati Children’s Hospital Medical Center
Center
Steven H. Itzkowitz, MD Los Angeles, California
Cincinnati, Ohio Professor of Medicine and Oncological
Sciences
Division of Gastroenterology Sarah A. Kearney, MD
Charles F. Haines, MD Department of Medicine Division of Adolescent Medicine
Division of Infectious Diseases Icahn School of Medicine at Mount Sinai Department of Pediatrics
Department of Medicine New York City, New York The Hospital for Sick Children
The Johns Hopkins University School of University of Toronto
Medicine Toronto, Ontario, Canada
Baltimore, Maryland
Dennis M. Jensen, MD
Professor of Medicine
Medicine—Gastroenterology Ciarán P. Kelly, MD
Heinz F. Hammer, MD 'DYLG*HͿHQ6FKRRORI0HGLFLQH Professor of Medicine
Associate Professor University of California, Los Angeles Gastroenterology
Gastroenterology and Hepatology 6WDͿ3K\VLFLDQ Harvard Medical School
Medical University Medicine—Gastroenterology Fellowship Program Director
Chief of Internal Medicine VA Greater Los Angeles Healthcare System Gastroenterology
Privatklinik Kastanienhof Key Investigator Beth Israel Deaconess Medical Center
Graz, Austria Director, Human Studies Core and GI Boston, Massachusetts
Hemostasis Research Unit
CURE Digestive Diseases Research Center
Shawn M. Hancock, DO Los Angeles, California
Colleen R. Kelly, MD
Clinical Instructor Clinical Assistant Professor of Medicine
Advanced Endoscopy Fellow Women’s Medicine Collaborative
Gastroenterology and Hepatology Robert T. Jensen, MD Alpert Medical School of Brown University
University of Wisconsin School of Medicine Chief, Cell Biology Section Providence, Rhode Island
and Public Health Digestive Diseases Branch, NIDDK
Madison, Wisconsin National Institutes of Health
Bethesda, Maryland
Arthur Y. Kim, MD
Division of Infectious Diseases
Stephen A. Harrison, MD Massachusetts General Hospital
Chief of Hepatology D. Rohan Jeyarajah, MD, PA Assistant Professor of Medicine
Medicine, Division of Gastroenterology Director, Surgical Oncology Harvard Medical School
Brooke Army Medical Center Director, HPB Fellowship Program Boston, Massachusetts
Fort Sam Houston, Texas Methodist Dallas Medical Center
Dallas, Texas
Kenneth L. Koch, MD
David J. Hass, MD Professor of Medicine
Assistant Clinical Professor of Medicine Peter J. Kahrilas, MD Department of Medicine
Division of Digestive Diseases Gilbert H. Marquartd Professor in Medicine Chief, Section on Gastroenterology
Yale University School of Medicine Northwestern University Wake Forest University School of Medicine
New Haven, Connecticut Feinberg School of Medicine Winston-Salem, North Carolina
Chicago, Illinois
Colin Hill, PhD, DSc Kris V. Kowdley, MD
Professor of Microbial Food Safety Patrick S. Kamath, MD Clinical Professor of Medicine
Alimentary Pharmabiotic Centre Professor of Medicine Gastroenterology
School of Microbiology Gastroenterology and Hepatology University of Washington
University College Cork Consultant Director of Research
Cork, Ireland Gastroenterology and Hepatology Director, The Liver Center of Excellence
Mayo Clinic Digestive Disease Institute
Rochester, Minnesota Virginia Mason Medical Center
Seattle, WashingtonAutori xi
Krzysztof Krawczynski, MD, PhD Hsiao C. Li, MD Carolina Malagelada, MD, PhD
Distinguished Consultant and Team Leader Assistant Professor Attending Gastroenterologist
Division of Viral Hepatitis Internal Medicine Digestive Diseases Department
Centers for Disease Control and Prevention University of Texas Southwestern Medical Hospital Universitari Vall d’Hebron
Atlanta, Georgia Center Autonomous University of Barcelona
Dallas, Texas Barcelona, Spain
J. Thomas Lamont, MD
Physician Gary R. Lichtenstein, MD Juan-R. Malagelada, MD
Division of Gastroenterology Professor of Medicine Associate Professor of Medicine
Beth Israel Deaconess Medical Center Division of Gastroenterology Autonomous University of Barcelona
Professor Raymond and Ruth Perelman School of Consultant
Harvard Medical School, Medicine of the University of Digestive Diseases Department
Boston, Massachusetts Pennsylvania Hospital Universitari Vall d’Hebron
'LUHFWRU&HQWHUIRU,QÁDPPDWRU\%RZHO Barcelona, Spain
Disease
Carmen Landaverde, MD Department of Medicine
Transplant Hepatologist Hospital of the University of Pennsylvania
Akiva Marcus, MD, PhD
Hepatology Division Philadelphia, Pennsylvania Division of Gastroenterology and Liver
Baylor University Medical Center Disease
Dallas, Texas Albert Einstein College of Medicine
Rodger A. Liddle, MD 0RQWHÀRUH0HGLFDO&HQWHU
Professor of Medicine Bronx, New York
Anne M. Larson, MD Department of Medicine
Director Duke University Medical Center
Swedish Liver Center Chief, Gastroenterology
Lawrence A. Mark, MD, PhD
Swedish Health Systems Medicine Assistant Professor
Seattle, Washington 9HWHUDQV$ͿDLUV0HGLFDO&HQWHU Dermatology
Durham, North Carolina Indiana University School of Medicine
Indianapolis, Indiana
James Y.W. Lau, MD
Professor of Surgery Steven D. Lidofsky, MD, PhD
Surgery Professor of Medicine
Paul Martin, MD
The Chinese University Hong Kong University of Vermont Chief, Division of Heaptology
Director College of Medicine University of Miami
Endoscopy Centre Director of Hepatology Miami, Florida
Prince of Wales Hospital Fletcher Allen Health Care
Hong Kong, China Burlington, Vermont Joel B. Mason, MD
Professor of Medicine and Nutrition
Jessica LeBlanc, MD Keith D. Lindor, MD Divisions of Gastroenterology and Clinical
Dermatology Resident Executive Vice Provost and Dean Nutrition
Dermatology College of Health Solutions Tufts Medical Center
Indiana University Arizona State University Director
Indianapolis, Indiana Professor of Medicine Vitamins and Carcinogenesis Laboratory
Gastroenterology and Hepatology USDA Human Nutrition Research Center
Mayo Clinic Hospital at Tufts University
Edward L. Lee, MD Boston, Massachusetts
Professor and Chair Phoenix, Arizona
Department of Pathology
Howard University College of Medicine Mark E. Lowe, MD, PhD Jeffrey B. Matthews, MD
Howard University Hospital Professor and Vice-Chairman Dallas B. Phemister Professor and Chairman
Washington, DC Pediatrics Surgery
University of Pittsburgh Medical School and The University of Chicago
Children’s Hospital of Pittsburgh of Chicago, Illinois
Anthony J. Lembo, MD
Associate Professor of Medicine UPMC
Harvard Medical School Pittsburgh, Pennsylvania Lloyd Mayer, MD†
Division of Gastroenterology
Beth Israel Deaconess Medical Center Ryan Madanick, MD Craig J. McClain, MD
Boston, Massachusetts Assistant Professor of Medicine Professor of Medicine
Division of Gastroenterology and University of Louisville
Mike A. Leonis, MD, PhD Hepatology Director, Gastroenterology
Associate Professor University of North Carolina Robley Rex VA Medical Center
Pediatrics School of Medicine Louisville, Kentucky
University of Cincinnati College of Medicine Chapel Hill, North Carolina
Attending Physician
George B. McDonald, MD
Cincinnati Children’s Hospital Medical Matthias Maiwald, MD, PhD
Center Professor of Medicine
Consultant in Microbiology Division of Gastroenterology
Cincinnati, Ohio Department of Pathology and Laboratory University of Washington
Medicine Member
James H. Lewis, MD KK Women’s and Children’s Hospital Clinical Research Division
Professor of Medicine, Director of Adjunct Associate Professor Fred Hutchinson Cancer Research Center
Hepatology Department of Microbiology Seattle, Washington
Division of Gastroenterology National University of Singapore
Georgetown University Medical Center Adjunct Associate Professor
Washington, DC Duke-NUS Graduate Medical School
Singaporexii Autori
Frederick H. Millham, MD Moises Ilan Nevah, MD Neal C. Patel, MD
Associate Clinical Professor of Surgery Assistant Professor of Medicine Assistant Professor of Medicine
Harvard Medical School Gastroenterology, Hepatology, and Nutrition Division of Gastroenterology
Boston, Massachusetts University of Texas Health Science Center at Mayo Clinic
Chair of Surgery Houston Scottsdale, Arizona
South Shore Hospital Houston, Texas
Weymouth, Massachusetts
Visiting Surgeon
V.S. Periyakoil, MD
Massachusetts General Hospital
Jeffrey A. Norton, MD Director, Palliative Care Education and
Boston, Massachusetts Professor of Surgery Training
Department of Surgery Clinical Associate Professor
Stanford University School of Medicine Medicine
Ginat W. Mirowski, DMD, MD Stanford, California Stanford University School of Medicine
Adjunct Associate Professor Stanford, California
Department of Oral Pathology Medicine
Radiology
Kjell Oberg, MD, PhD
Indiana University School of Dentistry Professor Robert Perrillo, MD
Indianapolis, Indiana Department of Endocrine Oncology Senior Hepatologist
University Hospital Hepatology Division
Uppsala, Sweden Baylor University Medical Center
Joseph Misdraji, MD Adjunct Professor Dallas, Texas
Associate Professor of Pathology Department of Surgery
Department of Pathology Vanderbilt University
Massachusetts General Hospital Nashville, Tennessee
Patrick R. Pfau, MD
Boston, Massachusetts Professor, Chief of Clinical Gastroenterology
Section of Gastroenterology and Hepatology
John O’Grady, MD University of Wisconsin School of Medicine
Jason S. Mizell, MD Professor and Public Health
Assistant Professor Institute of Liver Studies Madison, Wisconsin
Department of Surgery King’s College Hospital
University of Arkansas for Medical Sciences London, United Kingdom
Little Rock, Arkansas
Jonathan Potack, MD
Assistant Professor of Medicine
Roy C. Orlando, MD Division of Gastroenterology
Douglas R. Morgan, MD Mary Kay and Eugene Bozymski and Linda Department of Medicine
Associate Professor of Medicine and William Heizer Distinguished Icahn School of Medicine at Mount Sinai
Division of Gastroenterology, Hepatology, Professor of Gastroenterology New York, New York
and Nutrition Medicine
VIGH Director for Latin America Sites University of North Carolina at
Vanderbilt Institute for Global Health Chapel Hill
Daniel S. Pratt, MD
(VIGH) Chapel Hill, North Carolina Clinical Director, Liver Transplantation
Vanderbilt Ingram Cancer Center (VICC) Gastrointestinal Unit
Vanderbilt University Massachusetts General Hospital
Nashville, Tennessee
Mark T. Osterman, MD Assistant Professor of Medicine
Assistant Professor of Medicine Harvard Medical School
Hospital of the University of Pennsylvania Boston, Massachusetts
John Magaña Morton, MD Presbyterian Medical Center of Philadelphia
Associate Professor Philadelphia, Pennsylvania
Surgery
Michael Quante, MD
Stanford University Medical Center Internal Medicine II
Stanford, California
Manisha Palta, MD Technische Universität München
Assistant Professor Munich, Germany
Radiation Oncology
Sean J. Mulvihill, MD Duke University
Professor Durham, North Carolina
Eamonn M.M. Quigley, MD
Department of Surgery Professor of Medicine
$VVRFLDWH9LFH3UHVLGHQWIRU&OLQLFDO$ͿDLUV Weill Cornell Medical College
Health Sciences Center
Stephen J. Pandol, MD David M. Underwood Chair of Medicine in
CEO Professor of Medicine Digestive Disorders
University of Utah Medical Group University of California, Los Angeles Houston, Texas
University of Utah Director, Pancreatic Research
Salt Lake City, Utah Cedars-Sinai Medical Center
Los Angeles, California
B.S. Ramakrishna, MBBS, MD, DM, PhD
Director
Fatiha Nassir, PhD Institute of Gastroenterology
Division of Gastroenterology and
John E. Pandolfino, MD SRM Institutes for Medical Science
Hepatology Hans Popper Professor of Medicine Chennai, Tamil Nadu, India
University of Missouri Northwestern University
School of Medicine Feinberg School of Medicine
Chief
Francisco C. Ramirez, MD
Columbia, Missouri Professor of Medicine
Division of Gastroenterology and
Hepatology Division of Gastroenterology
Northwestern Medicine Mayo Clinic
Chicago, Illinois Scottsdale, ArizonaAutori xiii
Mrinalini C. Rao, PhD Marc E. Rothenberg, MD, PhD Jayashree Sarathy, PhD
Professor Director, Division of Allergy and Visiting Research Assistant Professor
Physiology and Biophysics, and Department Immunology Physiology and Biophysics
of Medicine, Division of Gastroenterology Department of Pediatrics University of Illinois at Chicago
and Hepatology Cincinnati Children’s Hospital Medical Chicago, Illinois
University of Illinois at Chicago Center Assistant Professor
Chicago, Illinois Director, Division of Allergy and Biological Sciences
Immunology Benedictine University
Department of Pediatrics Lisle, Illinois
Satish S.C. Rao, MD, PhD University of Cincinnati
Professor of Medicine Cincinnati, Ohio
Chief, Gastroenterology/Hepatology George A. Sarosi, Jr., MD
Director, Digestive Health Center Associate Professor
Medical College of Georgia Jayanta Roy-Chowdhury, MBBS Robert H. Hux, MD Professor
Georgia Regents University Professor Surgery
Augusta, Georgia Departments of Medicine and Genetics University of Florida College of Medicine
Albert Einstein College of Medicine 6WDͿ6XUJHRQ
New York, New York Surgical Service
John F. Reinus, MD NF/SG VAMC
Professor of Clinical Medicine Gainesville, Florida
Department of Medicine Namita Roy-Chowdhury, PhD
Albert Einstein College of Medicine Professor
Chief of Clinical Hepatology Departments of Medicine and Genetics Thomas J. Savides, MD
Division of Gastroenterology and Liver Albert Einstein College of Medicine Professor of Clinical Medicine
Diseases Bronx, New York Division of Gastroenterology
0RQWHÀRUH0HGLFDO&HQWHU University of California, San Diego
Bronx, New York La Jolla, California
Bruce A. Runyon, MD
Director of Hepatology
David A. Relman, MD University of California Medical Center, Mark A. Schattner, MD
Thomas C. and Joan M. Merigan Professor Santa Monica Associate Clinical Member
Departments of Medicine, and Microbiology Santa Monica, California Medicine
and Immunology Clinical Professor of Medicine Memorial Sloan-Kettering Cancer Center
Stanford University Division of Digestive Diseases Associate Professor of Clinical Medicine
Stanford, California 'DYLG*HͿHQ6FKRRORI0HGLFLQHDW8&/$ Medicine
Chief of Infectious Diseases Los Angeles, California Joan and Sanford I. Weill Medical College of
9HWHUDQV$ͿDLUV3DOR$OWR+HDOWK&DUH Cornell University
System New York, New York
Palo Alto, California
Michael A. Russo, MD
Assistant Professor of Pediatrics
Division of Pediatric Gastroenterology, James M. Scheiman, MD
Joel E. Richter, MD Hepatology, and Nutrition Professor
Professor and Director University of Texas Southwestern Medical Division of Gastroenterology
Division of Digestive Diseases and Nutrition School Department of Internal Medicine
Director Dallas, Texas University of Michigan Medical School
Joy McCann Culverhouse Center for Attending Physician Ann Arbor, Michigan
Swallowing Disorders Children’s Medical Center of Dallas at
University of South Florida Legacy
Tampa, Florida Plano, Texas
Lawrence R. Schiller, MD
Attending Physician
Digestive Health Associates of Texas
Eve A. Roberts, MD Hamid M. Said, PhD Baylor University Medical Center
Adjunct Professor Professor and Vice-Chair Dallas, Texas
Paediatrics, Medicine, and Pharmacology Medicine
University of Toronto University of California, Irvine
Adjunct Scientist Irvine, California
Mitchell L. Schubert, MD
Genetics and Genome Biology Professor of Medicine and Physiology
Hospital for Sick Children Research Institute Virginia Commonwealth University Health
Associate
Hugh A. Sampson, MD System
Division of Gastroenterology, Hepatology, Professor of Pediatrics Chief, Section of Gastroenterology
and Nutrition Pediatrics 0F*XLUH9HWHUDQV$ͿDLUV0HGLFDO&HQWHU
The Hospital for Sick Children Icahn School of Medicine at Mount Sinai Richmond, Virginia
Toronto, Ontario, Canada New York, New York
Cynthia L. Sears, MD
Andrew S. Ross, MD Bruce E. Sands, MD Professor of Medicine
Section Chief Dr. Burril B. Crohn Professor of Medicine Johns Hopkins University School of
Gastroenterology Department of Medicine Medicine
Virginia Mason Medical Center Icahn School of Medicine at Mount Sinai Baltimore, Maryland
Director, Therapeutic Endoscopy Center of Chief of the Dr. Henry D. Janowitz Division
Excellence of Gastroenterology
Mount Sinai Medical Center
Joseph H. Sellin, MD
Digestive Disease Institute Professor of Medicine
Virginia Mason Medical Center New York, New York
Division of Gastroenterology
Seattle, Washington Baylor College of Medicine
Chief of Gastroenterolgy
Ben Taub General Hospital
Houston, Texasxiv Autori
M. Gaith Semrin, MD, MBBS William M. Steinberg, MD Christopher C. Thompson, MD
Assistant Professor Clinical Professor of Medicine Director of Therapeutic Endoscopy
Pediatric Gastroenterology and Nutrition George Washington University Division of Gastroenterology, Hepatology,
University of Texas Southwestern Medical Washington, DC and Endoscopy
Center Brigham and Women’s Hospital
Children’s Medical Center—Dallas Associate Professor of Medicine
Dallas, Texas
Andrew H. Stockland, MD Harvard Medical School
Physician Boston, Massachusetts
Division of Vascular and Interventional
Vijay H. Shah, MD Radiology
Professor of Medicine and Physiology Mayo Clinic Dawn M. Torres, MD
Chair Rochester, Minnesota Chief, Hepatology
Division of Gastroenterology and Gastroentrology Service, Department of
Hepatology Medicine
Mayo Clinic
Neil H. Stollman, MD Walter Reed National Military Medical
Rochester, Minnesota Associate Clinical Professor Center
Department of Medicine, Division of Bethesda, Maryland
Gastroenterology
Fergus Shanahan, MD University of California, San Francisco
Professor and Chair San Francisco, California Timothy M. Trebble, MD
Medicine Chairman Consultant Gastroenterologist
University College Cork Department of Medicine Departments of Gastroenterology and
National University of Ireland Alta Bates Summit Medical Center Nutrition
Cork, Ireland Oakland, California Portsmouth Hospitals Trust
Portsmouth, United Kingdom
G. Thomas Shires, MD Frederick J. Suchy, MD
John P. Thompson Chair &KLHI5HVHDUFK2FHU'LUHFWRU7KH Richard H. Turnage, MD
Surgical Services Children’s Hospital Research Institute Professor and Chair
Texas Health Presbyterian Hospital Dallas Pediatrics Department of Surgery
Dallas, Texas Children’s Hospital Colorado University of Arkansas for Medical Sciences
Professor of Pediatrics and Associate Dean Little Rock, Arkansas
for Child Health Research
Corey A. Siegel, MD Pediatrics
Assistant Professor of Medicine and the University of Colorado School of Medicine
Dominique Charles Valla, MD
Dartmouth Institute for Health Policy and Aurora, Colorado Coordinator, DHU Unity
Clinical Practice Service d’Hepatologie
Hanover, New Hampshire Hôpital Beaujon
Director Christina M. Surawicz, MD Clichy, France
'DUWPRXWK+LWFKFRFN,QÁDPPDWRU\%RZHO Professor of Medicine Professor
Disease Center Medicine, Division of Gastroenterology Hepatology
Geisel School of Medicine University of Washington Université Paris Diderot
Lebanon, New Hampshire Seattle, Washington Paris, France
Maria H. Sjogren, MD Jan Tack, MD, PhD John J. Vargo II, MD
Senior Hepatologist Professor of Medicine, Head of Department Associate Professor of Medicine
Gastroenterology TARGID (Translational Research Center for Cleveland Clinic Lerner College of Medicine
Walter Reed National Military Medical Gastrointestinal Disorders) Gastroenterology and Hepatology
Center University of Leuven Vice Chairman, Digestive Disease Institute
Bethesda, Maryland Head of Clinic Cleveland Clinic
Gastroenterology Cleveland, Ohio
University Hospitals Leuven
Rhonda F. Souza, MD Leuven, Belgium
Professor of Medicine Axel von Herbay, MD
Division of Gastroenterology Professor of Pathology
VA North Texas Healthcare System Nicholas J. Talley, MD, PhD Doctor of Medicine
University of Texas Southwestern Medical Pro Vice-Chancellor and Professor Professor of Pathology
Center Faculty of Health Faculty of Medicine
Dallas, Texas University of Newcastle, University of Heidelberg
Newcastle, New South Wales, Australia Heidelberg, Germany
Cedric W. Spak, MD
Physician Scott Tenner, MD Arnold Wald, MD
Infectious Diseases Clinical Professor of Medicine Professor of Medicine
Baylor University Medical Center Division of Gastroenterology Division of Gastroenterology and
Dallas, Texas State University of New York Hepatology
Brooklyn, New York University of Wisconsin School of Medicine
and Public Health
Stuart Jon Spechler, MD Madison, Wisconsin
Chief, Division of Gastroenterology Narci C. Teoh, MBBS, PhD
VA North Texas Healthcare System Professor
Professor of Medicine, Berta M. and Cecil O. Gastroenterology and Hepatology Academic
Patterson Chair in Gastroenterology Unit of Internal Medicine, ANU Medical
University of Texas Southwestern Medical School
Center The Australian National University
Dallas, Texas Canberra, Capital Territory, AustraliaAutori xv
David Q.-H. Wang, MD, PhD David C. Whitcomb, MD, PhD Stephan G. Wyers, MD
Associate Professor of Medicine, Professor, and Chief, Division of Assistant Professor of Surgery
Biochemistry and Molecular Biology Gastroentrology, Hepatology, and University of Chicago Pritzker School of
Division of Gastroenterology and Nutrition Medicine
Hepatology, Department of Internal Medicine, Cell Biology and Molecular General Surgery
Medicine Physiology, and Human Genetics University of Chicago Medical Center
Saint Louis University School of Medicine University of Pittsburgh and UPMC Chicago, Illinois
St. Louis, Missouri Pittsburgh, Pennsylvania
Joseph C. Yarze, MD
Heiner Wedemeyer, MD C. Mel Wilcox, MD, MSPH Clinical Associate Professor of Medicine
Professor Professor of Medicine Albany Medical College
Gastroenterology, Hepatology and Division of Gastroenterology and Albany, New York
Endocrinology Hepatology Consultant
Hannover Medical School University of Alabama at Birmingham Gastroenterology Associates of Northern
Hannover, Germany Birmingham, Alabama New York
Medical Co-Director
Gastrointestinal Center
Jennifer T. Wells, MD Lalan S. Wilfong, MD Glens Falls Hospital
Hepatology Division Department of Internal Medicine Glens Falls, New York
Baylor University Medical Center Division of Hematology/Oncology
Dallas, Texas Texas Health Presbyterian Hospital Dallas
Dallas, Texas
Barry K. Wershil, MD
Professor Christopher G. Willett, MD
Pediatrics Professor and Chairman
Northwestern University Feinberg School of Radiation Oncology
Medicine Duke University
Chief, Division of Gastroenterology, Durham, North Carolina
Hepatology, and Nutrition
Pediatrics
Ann and Robert H. Lurie Children’s
Hospital of Chicago
Chicago, IllinoisPresentazione dell’edizione americana
La decima edizione di Gastrointestinal and Liver Disease: Patho- pubblicati nel 2014. Come indicato nella Prefazione, alcuni dei
physiology/Diagnosis/Management di Sleisenger e Fordtran è ancora nuovi capitoli contengono discussioni aggiornate su temi di
oggi uno dei testi di riferimento nel campo della gastroentero- attualità, come microbiota enterico, probiotici e trapianto di feci
logia e in quello dell’epatologia. HPDODWWLHJDVWURLQWHVWLQDOLÀWWL]LH4XHVWRWHVWRVLGLVWLQJXHSHU
È autorevole, esauriente e, sebbene enciclopedico nei temi la chiarezza, l’elevato dettaglio delle tabelle e l’elevata qualità
trattati, rimane una lettura piacevole e interessante. L’ottimo delle immagini microscopiche.
lavoro degli editors ha fatto sì che la struttura dei capitoli fosse La decima edizione di “Sleisenger e Fordtran”, così come
XQLIRUPH6RQRSHUFLzVXGGLYLVLQHLSDUDJUDÀGLHSLGHPLRORJLD
le precedenti, resterà un testo di primaria importanza e sarà
H]LRORJLDDVSHWWLLVWRORJLFLÀVLRSDWRORJLDVHJQLFOLQLFLGLDJQRVL
particolarmente utile a gastroenterologi e medici internisti sia
GLDJQRVLGLͿHUHQ]LDOHWUDWWDPHQWRHSURJQRVL/·RUJDQL]]D]LRQH
uniforme permette al lettore di ricercare con facilità le infor- VSHFLDOLVWLVLDLQIRUPD]LRQH,QÀQHVRQRLRVWHVVRWHVWLPRQHGHJOL
mazioni contenute nelle diverse sezioni e trovare risposte ai strabilianti sviluppi avvenuti nel corso degli anni: da autore del
propri interrogativi. Come sottolineato nella Prefazione, i conte- FDSLWRORVXOODJDVWURHQWHULWHHRVLQRÀODQHOODVHFRQGDHGL]LRQH
nuti trattati nel libro sono molto cambiati nel corso dei 42 anni credo che la lettura di questo stesso capitolo nella decima edi-
trascorsi dalla pubblicazione della prima edizione, nel 1973. zione metta bene in evidenza i progressi fatti nella comprensione
Mentre la prima edizione contava 115 capitoli, la decima ne GHOOHEDVLPROHFRODULHGHOODÀVLRSDWRORJLDGLTXHVWLGLVWXUELH
annovera 132: questi 17 capitoli supplementari testimoniano di quelli a essi associati.
la competenza di autori ed editors nel mantenere riferimenti
QRQVRORDLFRQWHQXWLFODVVLFLPDDQFKHDLSURJUHVVLVFLHQWLÀFL
occorsi negli anni tra la prima edizione e le successive. I con- Norton J. Greenberger, MD
tenuti più recenti e aggiornati includono riferimenti ad articoli Boston, Massachusetts
xviiDa sinistra: Mark Feldman, MD; Lawrence S. Friedman, MD; Lawrence J. Brandt, MD.
Prefazione dell’edizione americana
La decima edizione di Gastrointestinal and Liver Disease: Pathophy- accompagnati dalle descrizioni delle procedure. Gli autori sono
siology/Diagnosis/Management di Sleisenger e Fordtran fa parte estremamente grati a Gregory G. Ginsberg, Christopher J. Gostout,
di un gruppo selezionato di libri di testo che, per molti anni, Michael L. Kochman, Ian D. Norton e il personale di Elsevier per
sono stati una risorsa preziosa per i lettori. Marvin Sleisenger e aver consentito ai nostri lettori l’accesso a questo straordinario
John S. Fordtran iniziarono a lavorarci più di 40 anni fa e i loro materiale educativo.
sforzi culminarono con la pubblicazione della prima edizione, Fortunatamente, grazie all’aiuto dei nostri illustri collabora-
Gastrointestinal Disease, nel 1973. Da allora è accaduto molto tori, il contenuto del testo rimane senza eguali. Il confronto tra i
nel campo della gastroenterologia e ogni edizione successiva contenuti della prima e quelli della decima edizione permette di
del testo ha incorporato meticolosamente questi entusiasmanti apprezzare a pieno gli straordinari progressi fatti nel campo. Nel
progressi. Tra questi si annoverano una conoscenza più solida 1973 non eravamo a conoscenza di numerose condizioni cliniche
dei meccanismi che sono alla base della salute e della malattia a che sono oggigiorno al centro della pratica gastroenterologica.
livello cellulare, subcellulare, genetico e molecolare; una migliore Inoltre, il paragone tra la sezione di epatologia nella sesta edi-
FRPSUHQVLRQHGHOODÀVLRSDWRORJLDGHOOHPDODWWLHJDVWURLQWHVWLQDOL zione (1998) e l’attuale è un’ulteriore prova delle scoperte che
e delle epatopatie; l’introduzione di nuovi esami e procedure hanno portato a importanti miglioramenti nella diagnosi e nel
diagnostici (molti dei quali hanno sostituito esami e procedure trattamento delle epatopatie, in particolare per quanto riguarda
ora obsolete); la combinazione dell’endoscopia diagnostica con i farmaci per la cura dell’epatite virale cronica.
la terapeutica; lo sviluppo di nuovi agenti farmacologici e di La decima edizione include tre capitoli degni di nota e che non
classi di farmaci per condizioni mediche per le quali non vi era erano presenti nelle edizioni precedenti. Un intero capitolo, il cui
alcun trattamento; l’applicazione della chirurgia laparoscopica autore è Fergus Shanahan, dedicato al microbiota intestinale e un
in numerosi disturbi gastrointestinali e molti altri. altro, di Christina Surawicz e Lawrence J. Brandt, su probiotici
Nei suoi 42 anni di vita, questo testo ha avuto sei editors: HWUDSLDQWRGLPLFURELRWDIHFDOH4XHVWHDJJLXQWHULÁHWWRQROD
Marvin H. Sleisenger e John S. Fordtran (fondatori), Mark Feld- QRVWUDDYDQ]DWDFRQRVFHQ]DGHOODÁRUDLQWHVWLQDOHHODQRVWUD
man, Bruce F. Scharschmidt, Lawrence S. Friedman e Lawrence crescente comprensione del ruolo del microbiota intestinale nella
J. Brandt. Questi hanno avuto la fortuna di coinvolgere centinaia patogenesi e nel trattamento di malattie gastrointestinali (e non
di ottimi autori e collaboratori provenienti da tutto il mondo, solo), in particolare della colite da &ORVWULGLXPGLFLOH. Gli editors
i quali hanno generosamente condiviso le loro conoscenze e sono anche felici di accogliere di nuovo John S. Fordtran il quale,
competenze con i lettori. Inoltre, durante tutto il corso della con Marc D. Feldman, ha lavorato a un capitolo magistrale sulle
pubblicazione del libro, gli editors hanno potuto contare sul PDODWWLHJDVWURLQWHVWLQDOLÀWWL]LHXQLQVLHPHGLGLVWXUELFKHSRV-
sostegno di una casa editrice competente e professionale come sono rivelarsi ardue da diagnosticare e trattare per il medico.
Elsevier. Altri cambiamenti rispetto alla nona edizione sono l’inclusione
La prima edizione di Gastrointestinal Disease, pubblicata nel dell’endoscopia nel capitolo “Trattamento chirurgico ed endo-
scopico dell’obesità” e della preparazione all’endoscopia nel
1973, era piuttosto diversa dalla presente, la decima. La prima
capitolo “Endoscopia digestiva: preparazione e complicanze”; la
edizione è stata pubblicata in un singolo volume con meno di 1600
fusione dei capitoli “Malattia ulcerosa peptica” e “Trattamento
pagine, di cui più di 200 dedicate a un unico argomento: l’ulcera
della malattia ulcerosa peptica” in un unico capitolo; l’aggiunta
peptica. La prima edizione contava 115 capitoli, la decima 132.
di un nuovo capitolo “Cirrosi, cenni generali”; la separazione
Oltre ai due editors e fondatori, la prima edizione ha coinvolto
del capitolo sull’epatite B e D in due distinti; la divisione del
55 autori, mentre la decima 217. La prima edizione è stata scritta
capitolo “Digestione e assorbimento di vitamine e minerali” in
quasi totalmente da autori statunitensi, mentre alla decima edizione “Digestione e assorbimento dei macronutrienti” e “Digestione
hanno contribuito autori da 15 Paesi. La gran parte dei capitoli e assorbimento intestinale di micronutrienti”. In questa decima
nella prima edizione aveva un solo autore, mentre molti ne hanno edizione siamo lieti di dare il benvenuto non solo a molti nuovi
ora due. Forse ancora più importante è il fatto che l’epatopatia, autori, ma anche il bentornato a quelli già incontrati nelle pre-
non trattata né nella prima edizione né nelle quattro successive, cedenti edizioni.
sia stata introdotta nel testo a partire dalla sesta edizione – il In conclusione, gli editors desiderano ringraziare Kate Dimock,
cui titolo è stato cambiato in Gastrointestinal and Liver Disease: Suzanne Toppy, Deidre (Dee) Simpson e Cindy Thoms di Elsevier,
Pathophysiology/Diagnosis/Management – pubblicata per la prima il cui contributo competente ed entusiastico ha reso possibile la
volta nel 1998. Nel 2007, la British Medical Association ha conferito pubblicazione di questa decima edizione. Senza il loro sostegno e la
all’ottava edizione il First Prize nel campo della gastroenterologia. loro visione, gli editors non sarebbero stati in grado di mantenere
La prima edizione era disponibile ai lettori esclusivamente gli elevati standard stabiliti delle edizioni precedenti, standard
in formato cartaceo e l’uso dei colori era molto limitato. Con il che siamo determinati a mantenere.
passare del tempo, il testo è stato reso disponibile in CD-ROM e,
successivamente, online su un sito web dedicato. Con un maggior
Mark Feldman, MD
utilizzo di illustrazioni a colori si è ottenuta una migliore presen-
tazione delle immagini endoscopiche e istopatologiche. Oggi, i Lawrence S. Friedman, MD
contenuti della decima edizione possono essere visualizzati su Lawrence J. Brandt, MD
palmari e dispositivi portatili come smartphone, tablet e Kindle.
La versione online della decima edizione include anche decine
di video che illustrano approcci diagnostici e terapeutici e sono
xixPresentazione dell’edizione italiana
Presentare l’edizione italiana di un testo di Gastroenterologia allo studente di Medicina e Chirurgia le nozioni indispensabili
quale Sleisenger e Fordtran’s – 0DODWWLHJDVWURLQWHVWLQDOLHGHSDWLFKH, alla sua formazione. Ciò deriva dalla particolare struttura del
ormai giunto alla decima edizione, è per me un grande onore, testo, che parte dai sintomi di una malattia e dalla sua presen-
ma allo stesso tempo sento sulle spalle tutta la responsabilità WD]LRQHFOLQLFDQHDͿURQWDLQPDQLHUDSUHFLVDHGHWWDJOLDWDOD
che tale incarico comporta, accompagnata da un profondo senso ÀVLRSDWRORJLDQHGLVFXWHODGLDJQRVWLFDGLͿHUHQ]LDOHJXLGDQGR
di gratitudine. Tali sentimenti mi hanno spinta ad accettare l’in- il lettore verso la diagnosi, e ne imposta la terapia. Dal testo,
carico di occuparmi della curatela dell’edizione italiana a nome quindi, deriva sia il sapere sia il saper fare, anche per lo studente.
di tutti i docenti italiani di Malattie dell’Apparato Digerente. A L’essere lo strumento stabile e costante per tutti quelli che impa-
lavoro ultimato, posso confermare che ciascuna delle persone rano o insegnano la Gastroenterologia deriva altresì dal livello
coinvolte nella stesura della traduzione dell’opera ha messo a degli autori del testo originale, scelti per la stesura dell’opera
disposizione la propria professionalità con entusiasmo, dedizione fra quelli maggiormente esperti nella singola patologia. L’edi-
e orgoglio. Ringrazio pertanto, a nome di tutti i colleghi che zione italiana, curata da UNIGASTRO, aggiunge, a mio parere,
rappresento, la casa editrice Edra per averci coinvolto in questa un valore aggiunto a tale volume, rendendolo uno strumento
impresa. Tanto entusiasmo e tanto orgoglio derivano dal fatto più facilmente utilizzabile, sia nella comunità accademica sia
che “Sleisenger e Fordtran’s” rappresenta da sempre, per tutti nella pratica clinica quotidiana, da parte dei gastroenterologi
noi, il punto di riferimento sia nella formazione specialistica, sia italiani. Un grazie di cuore, pertanto, non solo all’editore, ma
nella consultazione di pratica clinica. Lo chiamiamo “per nome” anche, in particolare, a tutti i colleghi che hanno partecipato
perché è “l’amico” che ci accompagna nel lavoro di tutti i giorni alla realizzazione dell’edizione italiana, dimostrando, con la
e nessuno ha mai pensato di poterne fare a meno. Abbiamo propria competenza, la propria indole di formatori e docenti
tutti studiato su questo testo e ancora lo consultiamo. Per noi HXQDVSLFFDWDSURSHQVLRQHDOODGLͿXVLRQHGHOVDSHUHPHGLFR
docenti, inoltre, esiste una valenza aggiuntiva, che è quella di
potervi fare riferimento anche per quanto riguarda l’attività
didattica. Infatti, se nella formazione specialistica è utile per Prof.ssa Carmelina Loguercio
imparare, nella nostra attività attuale di docenti della materia Presidente UNIGASTRO – Coordinamento nazionale dei docenti
esso è fondamentale per insegnare e quindi per trasmettere anche di Gastroenterologia
xxiCuratori dell’edizione italiana
&RRUGLQDPHQWRDFXUDGL
Carmelina Loguercio
Università degli Studi della Campania “Luigi Vanvitelli”, Napoli
Ludovico Abenavoli Vincenza Calvaruso Rosario Cuomo
Università degli Studi “Magna Graecia” Università degli Studi di Palermo Università degli Studi di Napoli
di Catanzaro “Federico II”
Nicola Caporaso
Domenico Alvaro Università degli Studi di Napoli Giancarlo D’Ambra
“Sapienza” Università di Roma “Federico II” “Sapienza” Università di Roma
Bruno Annibale Vincenzo Cardinale Nicola De Bortoli
“Sapienza” Università di Roma “Sapienza” Università di Roma Università di Pisa
Adolfo Francesco Attili Fabiana Castiglione Roberto De Franchis
“Sapienza” Università di Roma Università degli Studi di Napoli Università degli Studi di Milano
“Federico II”
Danilo Badiali Adriano De Santis
“Sapienza” Università di Roma Giulia Martina Cavestro “Sapienza” Università di Roma
8QLYHUVLWj9LWD6DOXWH6DQ5DͿDHOH
Leonardo Baiocchi Milano Alessandra Dell’Era
Università degli Studi di Roma Università degli Studi di Milano
“Tor Vergata” Carolina Ciacci
Università degli Studi di Salerno Emilio Di Giulio
Monia Baldoni “Sapienza” Università di Roma
Università degli Studi di Perugia Alessia Ciancio
Università degli Studi di Torino Alfredo Di Leo
Michele Barone Università degli Studi di Bari
Università degli Studi di Bari Rachele Ciccocioppo “Aldo Moro”
“Aldo Moro” Università degli Studi di Verona
Massimo Claudio Fantini
Antonio Benedetti Enrico Stefano Corazziari Università degli Studi di Roma
Università Politecnica delle Marche “Sapienza” Università di Roma “Tor Vergata”
Livia Biancone Vito Domenico Corleto Fabio Farinati
Università degli Studi di Roma “Sapienza” Università di Roma Università degli Studi di Padova
“Tor Vergata”
Stefano Giovanni Corradini Alessandro Federico
Patrizia Burra “Sapienza” Università di Roma Università degli Studi della Campania
Università degli Studi di Padova “Luigi Vanvitelli”, Napoli
xxiiixxiv Curatori dell’edizione italiana
Davide Festi Manuela Merli Francesco Paolo Russo
“Alma Mater Studiorum” “Sapienza” Università di Roma Università degli Studi di Padova
Università di Bologna
Marco Montagnani Giorgio Maria Saracco
Annarosa Floreani “Alma Mater Studiorum” Università degli Studi di Torino
Università degli Studi di Padova Università di Bologna
Edoardo Vincenzo Savarino
Giuseppe Frieri Olivia Morelli Università degli Studi di Padova
Università degli Studi dell’Aquila Università degli Studi di Perugia
Vincenzo Savarino
Luca Frulloni Filomena Morisco Università degli Studi di Genova
Università degli Studi di Verona Università degli Studi di Napoli
“Federico II” Carola Severi
Andrea Galli “Sapienza” Università di Roma
Università degli Studi di Firenze Gerardo Nardone
Università degli Studi di Napoli Giacomo Sturniolo
Antonio Gasbarrini “Federico II” Università degli Studi di Padova
Università Cattolica del Sacro Cuore,
Roma Nadia Pallotta Mirko Tarocchi
“Sapienza” Università di Roma Università degli Studi di Firenze
Edoardo Giovanni Giannini
Università degli Studi di Genova Mariabeatrice Principi Paolo Usai
Università degli Studi di Bari Università degli Studi di Cagliari
Laurino Grossi “Aldo Moro”
Università degli Studi “G. d’Annunzio”, Piero Vernia
Chieti-Pescara Gian Ludovico Rapaccini
“Sapienza” Università di Roma
Università Cattolica del Sacro Cuore,
Edith Lahner Roma
Rocco Maurizio Zagari
“Sapienza” Università di Roma “Alma Mater Studiorum”
Giorgio Ricci
Università di Bologna
Giovanni Latella Università degli Studi di Ferrara
Università degli Studi dell’Aquila Patrizia Zentilin
Gabriele Riegler
Università degli Studi di Genova
Giovanni Maconi Università degli Studi della Campania
Università degli Studi di Milano “Luigi Vanvitelli”, Napoli
Santino Marchi Marco Romano
Università di Pisa Università degli Studi della Campania
“Luigi Vanvitelli”, NapoliPuoi anche leggere
