. Surgery, its principles and practice . esamong seven hundred and seventy. * Benign tumors are not common. Deaver found two cases of one case the patient had fibromyomata of the uterus. 746 SURGERY OF THE APPENDIX VERMIFORMIS. At present there are on record about forty cases of primary carcinomata of theappendix. Strangely enough, all were reported within the last ten years, whichsuggests the probabihty of more extensive and more careful examination of allappendices removed recently. Rolleston and Jones* collected thirty-seven cases ofprimary carcinoma. The youngest patient wa
. Surgery, its principles and practice . esamong seven hundred and seventy. * Benign tumors are not common. Deaver found two cases of one case the patient had fibromyomata of the uterus. 746 SURGERY OF THE APPENDIX VERMIFORMIS. At present there are on record about forty cases of primary carcinomata of theappendix. Strangely enough, all were reported within the last ten years, whichsuggests the probabihty of more extensive and more careful examination of allappendices removed recently. Rolleston and Jones* collected thirty-seven cases ofprimary carcinoma. The youngest patient was twelve (Letulle and Weinberg), theoldest were sixty-six and eighty-one (Kelly, Elting), the average being years Further, the age-incidence varies in the different kinds of carcinomata ofthe vermiform appendix, being fifty-two years in the columnar-celled, thirty-twoin the transitional forms, twenty-four in the spheroidal-celled, and in thosemerely described as carcinoma. Sex.—There is no marked preponderance of either Fig. 418.—Topography of Secondary Abscess as it Appears to the Left of the Mesosig-MOiD, having Ascended from the Pelvis. This neoplasm has a predilection for the tip or its vicinity. Concretions werepresent in only three cases, showing that irritation was not an important excitingfactor, as is usually the case elsewhere. The coats of the appendix showed inflamma-tory changes, which suggests the possibility of some relationship between inflamma-tion and malignancy. Carcinoma of the appendix gives no especial malignancy of the neoplasm is not great, as recurrence was rare in the operatedcases reported. Pre=operative Complications.—Peritonitis.—The pus may escapeinto the peritoneal cavity and produce an acute peritonitis, tlie severity TYPHLITIS, PERITYPHLITIS, EPITYPHLITIS. 747 of which depends upon the type of infecting micro-organism and itsdegree of virulence. In many cases, however, the abscess is limited to theperia
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