I was called, in this very unusual case, on the night of July 28. A boy, aged 4 years, with a good previous history, was found to be suffering from a typical acute attack of appendicitis, and was removed to the hospital for immediate operation. Under anesthesia the mass over McBurney's point was not only palpable but readily discernible by all present.
When the abdomen was opened, there was a slight flow of brownish fluid; the mass, which was discovered to be the head of the cecum, persistently protuded itself within the field of operation, so that it was necessary to enlarge the incision. Diligent and painstaking search for the appendix revealed only a perfectly formed cecum and ileum, but not a vestige of an appendix, not even a dimple on the cecum that might have revealed a possible collapsed or inverted appendix. The cecum and ileum could easily be