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William H. German, M.D.
JAMA. 1922;79(24):2001. doi:10.1001/jama.1922.26420240006013i.
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D. S., a girl, aged 6 years and 10 months, gave no history of illness, except that she had scarlet fever in 1921. She is said to have complained of occasional pain in the abdomen, but it was not thought serious, and she appeared normal.

July 9, 1922, she accidentally fell over a small rocking chair, and soon developed severe pain in the umbilical and left abdominal regions. July 30, examination revealed general abdominal rigidity and tension, tenderness over the appendix and a distinct tumor in the left abdomen. The temperature was 101. The bowels were obstinately constipated. July 31, the general condition was worse; pain had increased and vomiting had occurred. The patient was removed to a hospital for further observation and probable operation. The blood count revealed 23,350 leukocytes. The patient was prepared for operation, which was performed, July 31.

A medial incision was made, and a tumor


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