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Clinical Problems in General Medicine and Surgery
Commissioning Editor: Laurence Hunter Project Development Manager: Hannah Kenner Project Manager: Frances Affleck Designer: Sarah Russell
Clinical Problems in General Medicine and Surgery SECOND EDITION
Peter Devitt Associate Professor Department of Surgery Royal Adelaide Hospital Adelaide, Australia
Juliet Barker Assistant Professor Department of Medicine University of Minnesota Minneapolis, USA
Jonathan Mitchell Clinical Fellow in Hepatology Institute of Liver Studies Kings College Hospital London, UK
Christian Hamilton-Craig Medical Registrar St Vincent's Hospital; Associate Lecturer University of New South Wales Sydney, Australia
Foreword by Roy Pounder Professor of Medicine Royal Free & University College Medical School London, UK CHURCHILL LIVINGSTONE EDINBURGH LONDON NEW YORK OXFORD PHILADELPHIA ST LOUIS SYDNEY TORONTO 2003
CHURCHILL LIVINGSTONE © Harcourt Brace Jovanovich Croup (Australia) Pty Ltd 1992 © 2003, Elsevier Science Limited. All rights reserved. The right of Peter Devitt, Juliet Barker, Jonathan Mitchell and Christian Hamilton-Craig to be identified as editors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T4LP. Permissions may be sought directly from Elsevier's Health Sciences Rights Department in Philadelphia, USA: phone: (+1) 215 238 7869, fax: (+1) 215 238 2239, e-mail: