RESUMO
Taking as their starting point the observation of an isolated case of appendicocecal invagination in a homogeneous series of 4,200 appendicectomies observed, the authors take the opportunity of addressing in some detail the many aspects of the problem posed by this rare condition. With the aid of a review of the literature, an attempt is made to define and explain the aetiology, pathogenesis and classification of such forms. The authors review the various clinical criteria and instrumental aids available for reaching a correct diagnosis, assessing their respective virtues and defects, especially as regards the radiological, ultrasonographic and endoscopic investigations used; they come to the conclusion that none of these is in itself specific for this condition, and stress that a clinical suspicion of appendicocecal invagination can only emerge of the basis of an overall assessment of the various test findings in conjunction with actual clinical experience. Lastly, the authors review the therapeutic possibilities and conclude that surgical therapy, which varies from case to case, is the most reliable approach, in that the endoscopic therapy attempted by some cassies an excessively high degree of risk.
