Because of the many instances in which compensation has been denied, trauma as a factor in producing appendicitis deserves attention. The pathologic evidence agrees with well known experimental observations. When there is a history of trauma to the abdominal wall, followed by symptoms and signs of peritoneal irritation, the examiner should bear in mind the possibility of an inflammation of the appendix. Von Neumann1 reported that trauma plays a part in the cause of acute appendicitis in 6.6 per cent of the cases. The four cases reported here occurred in 101 appendectomies, making trauma an etiologic factor in 4 per cent.
The Idaho Commission2 said that appendicitis from strain is not a probability, and rarely, if ever, occurs.
In a case3 which occurred in California, the employee suffered a strain while lifting heavy objects, and felt a severe abdominal pain. Autopsy six days later revealed a ruptured