Much of the confusion which arises from a discussion of chronic appendicitis is due to the fact that it is not always specified whether the point of view is that of the pathologist or that of the clinician. The clinician has in mind a very definite syndrome when he speaks of acute appendicitis: A patient who has previously been well has a sudden severe pain in the abdomen, referred first to the epigastrium, with accompanying nausea, and possibly vomiting; a slight increase of pulse rate, with slight elevation of temperature; a chilly sensation, an appreciable increase of the leukocytes, and sooner or later tenderness over McBurney's point. On immediate opening of the abdomen there is sufficient evidence to warrant the diagnosis of an acute appendicitis. The pathologist, standing by, may at first see nothing more; but on closer examination he will find either macroscopic or microscopic evidence of a former
LICHTY JA. CHRONIC APPENDICITIS. JAMA. 1922;79(11):887–893. doi:10.1001/jama.1922.02640110027008
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