Simple ulcer of the caecum.

In a paper in the POSTGRADUATE MEDICAL JOURNAL we reported four cases of ' simple' ulcer in the colon. The following two examples are now presented as a sequel to this: Case i.-M.C., female, aged 14 years. This child presented with a history of two weeks' intermittent central abdominal pain; the pain was colicky, but not severe enough to incapacitate her. Two days before admission to hospital the pain became more severe and she developed a steady pain in the right iliac fossa. She vomited food taken after this and her appetite disappeared. Clinical examination showed a healthy young girl with a localized area of tenderness in the right iliac fossa; Rovsing's sign was positive and there was rebound tenderness. Temperature was 99.60; pulse I20. A diagnosis of appendicitis was made and the abdomen explored; the appendix was found to be normal, but there was an ulcer palpable on the posterior wall of the caecum at the level of the ileo-caecal valve.