To the Editor.—Standard anatomical and surgical texts state that the vermiform appendix is located in the retrocecal position in about two thirds of patients and in the pelvic position in about one third of patients. Does acute appendicitis occur, however, two thirds of the time in patients who have their appendices in the retrocecal position?
The operative records of 100 patients who underwent appendectomy at the Cleveland Clinic between 1965 and 1975 for acute appendicitis were studied and the position of the appendix was noted. In all cases, the pathological diagnosis was acute appendicitis. Patients in whom the diagnosis was other than acute appendicitis were excluded, as were cases in which the surgeon did not specifically mention the anatomical location of the inflamed appendix.
In 30 patients, the inflamed appendix was retrocecal. In 70 patients, the appendix was in a position other than the retrocecal position, primarily pelvic. Subileal