The following case is of particular interest, not so much on account of the abnormal position of the appendix, as on account of the coincident abnormal position of the right tube.
The three causes of abnormal position of the appendix are: first, an abnormal length of the mesentery; second, arrested fetal development, and, third, inflammatory conditions.
In this case the mesentery was not elongated and the position of the appendix is best explained by a salpingitis following a definite history of pelvic infection shortly after marriage. At some subsequent period an exacerbation of the pelvic condition resulted in the adhesion of the tube to the cecum. The extension of the perisalpingitis to an appendix normally dipping toward the pelvis resulted in an inflammation of the appendix with adhesions of the appendix to the uterus.
The appendix normally assumes the pelvic position in about 25 per cent. of cases (Kelly); and