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Francis Brewer, M.D.
JAMA. 1926;87(13):1037. doi:10.1001/jama.1926.92680130002015a.
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A Chinese soldier, aged 32, had three attacks of abdominal pain in the past ten years. The present, or fourth, attack lasted about twenty-four hours, with severe colic in the epigastrium, vomiting once, and constipation. Examination showed deep tenderness at McBurney's point, but no rigidity. The temperature was 99.4; the total white count, 13,800. Appendectomy relieved the symptoms.

The proximal half of the appendix was bound down to the ileocecal junction by peritoneum. It was 8 cm. long and 1.5 cm. in diameter, with a smooth, white surface, tightly distended, fluctuating, and possessing hydatid fremitus. When opened, a cyst cavity was revealed containing many secondary and tertiary cysts. This cavity extended from the tip to the narrowed base of the appendix, where the lumen was obliterated. A small, incompletely separated compartment at the tip suggested that the process may have started here in the wall of the appendix.


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