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Imaging pulmonary arteriovenous malformations.

so fewer infections in adolescence. He explains the link between appendicitis and the consumption of potato and sugar by the association of these cheap foodstuffs with poverty, which in turn goes with overcrowding and more virus infections. This is an ingenious and plausible theory even if it has overtones of having your cake and eating it-it blames absence of infections in infancy and then the presence of infections in adolescence. No serious objections were raised to it at the Southampton conference, but the hypothesis needs more supporting data and will not explain everything. Some older people do have faecoliths blocking their inflamed appendix. Perhaps constipation is the main risk factor in older people and lymphatic swelling induced by viraemia the main one in young people. Other factors-such as a change in bacterial flora or spasm in the caecum-could also play a part. Much research still needs to be done before we can say we fully understand acute appendicitis. KW HEATON