There is an ever present fear in the minds of surgeons of failing to recognize acute appendicitis. High mortality and prolonged morbidity are still prevalent as a result of delayed operative intervention. On the other hand, the frequently expressed opinion that it is better to operate in cases in which the diagnosis is incorrect than to overlook a bad appendix has carried physicians far afield. As a result of this state of mind, little thought is given to many diseases presenting symptoms that closely resemble the syndrome of acute appendicitis. The pathologic report on a removed appendix is often no criterion of the actual condition of the abdomen. Such changes as congestion or cellular infiltration are frequently only a comparatively small part of a pathologic process originating elsewhere in the abdomen.
It is of comparatively recent date that mesenteric adenitis has received some attention in medical literature; many of the