Few physicians fail to consider the vermiform appendix as the first and most probable cause of acute disease in the lower right portion of the abdomen. However, we sometimes overlook other conditions in this region, one of which is acute, primary typhlitis. Acute, primary typhlitis is but little mentioned in the ordinary textbooks, and we were able to find only sixteen cases reported in the literature in which the condition was found anatomically, either at operation or at necropsy, and without primary involvement of the appendix or adjacent tissues.
The recognition of acute primary typhlitis is of the greatest importance, however, after the abdomen is opened, as it is practically impossible to distinguish clinically between this condition and acute appendicitis with our present methods of examination. This is amply illustrated by our two cases, in which the diagnosis of acute appendicitis was made and in which immediate operation was performed.