In predicting what would happen in the year 1939, Bowers once asserted, 20,000 persons will die of appendicitis at an average age of 27, their most productive period. Fewer than 2,000 will die of appendicitis, but 17,000 will die of peritonitis arising therefrom. Of the 300,000 who will be operated on for unruptured appendicitis, approximately only 1 per cent will die. Of 105,000 persons who will have peritonitis, one out of every six will die; 42,000 will have spreading peritonitis and more than 15,000, or one in three, will die. Over 80 per cent of those who die will die of spreading peritonitis. This situation constitutes a real challenge to the surgeon.
Fitz says "Appendicitis, in spite of being a fashionable and well studied disease for more than fifty years, continues to slap our faces insultingly." Surgeons have encountered a gradually diminishing number of patients with spreading peritonitis, but in
HAGGARD WD, KIRTLEY JA. TREATMENT OF ACUTE SPREADING PERITONITIS FOLLOWING RUPTURED APPENDIX. JAMA. 1940;114(19):1843-1846. doi:10.1001/jama.1940.02810190005002