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May 13, 1939


Author Affiliations

Toledo, Ohio

JAMA. 1939;112(19):1935-1936. doi:10.1001/jama.1939.62800190003012b

V. R., a high school girl aged 16, was admitted to the hospital Aug. 10, 1935. She had been in good health except for what she termed minor attacks of indigestion intermittently during the past two years. The attacks were never serious enough for her to consult her physician. On the morning of August 9 after arising she was taken with a dull aching pain in the right lower quadrant of the abdomen which did not radiate. The patient suffered profound nausea and vomited seven times during the day. There was no history of constipation and her menstrual periods were regular.

On admission to the hospital the patient's temperature was 100 F., the pulse 110 and the leukocyte count, 30,700. There was a definite palpable tumor mass in the right lower quadrant of the abdomen, exquisite tenderness over McBurney's point and an early peritoneal reflex. There was no abdominal distention;