Last revised by Ammar Ashraf on 5 Jul 2023

The cecum (plural: ceca or cecums) is the first part of the large bowel and lies in the right lower quadrant of the abdomen. 

Blind-ending sac of bowel that lies below the ileocecal valve, above which the large intestine continues as the ascending colon. The cecum measures 6 cm in length and can have a maximum diameter of 9 cm before it is considered abnormally enlarged. The vermiform appendix typically arises from the posteromedial surface, 2 cm inferior to the ileocecal valve 1.

The cecum is covered by peritoneum, except posteriorly where it has a layer of loose connective tissue and it has a variable mesentery 1

The superior margin of the cecum is defined by the ileocecal ostium. Upper and lower flaps consisting of smooth muscle protrude into the lumen around the ostium forming the ileocecal valve 2. Its competence is often shown by the lack of contrast reflux into the terminal ileum on contrast enema studies.

  • lymphatic network runs parallel to the arterial supply, to paracolic lymph nodes, which drain to the superior mesenteric group
  • subhepatic cecum: failure of the cecum to migrate to its typical position during midgut rotation in embryogenesis 3
  • mobile cecum
    • right colonic mesentery fails to fuse to the lateral peritoneum 4
    • occurs in ~15% of the population 4

Cecum is short for the Latin term "intestinum cecum", which means blind gut.

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Cases and figures

  • Case 1: labeled 27
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  • Case 2: labeled 38
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  • Figure 1: normal relationship
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  • Case 3: labeled 9
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  • Figure 2
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  • Case 4: mobile cecum indenting the bladder
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  • Case 5: adenocarcinoma of the cecum
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