Presentation
Known cryptogenic hepatic cirrhosis, follow-up imaging.
Patient Data
Age: 40 years
Gender: Male
From the case:
Mobile cecum
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CT study shows the following:
- shrunken cirrhotic liver with no hepatic focal lesions, splenomegaly, and dilated homogeneously enhanced portal vein
- right renal lower calyceal stones with mild to moderate hydronephrosis that terminated at the UPJ with the non-dilated ureter; the UPJ and proximal ureter appear kinked with adjacent retroperitoneal fat blurring and confluent calcifications; an accessory renal artery is seen crossing the UPJ/proximal ureter
- the mobile cecum is seen reaching the deep pelvis abutting the posterior urinary bladder wall; the appendix is seen at the midline
From the case:
Mobile cecum
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The yellow line outlines the cecum and the green line outlines the appendix.
Case Discussion
A mobile cecum is an anatomical variant and is often defined as a failure of the cecum, terminal ileum, and right colon, along with the mesentery, to fuse to the posterior parietal peritoneal wall. This results in increased mobility of the cecum.
It is asymptomatic in many cases, but if symptomatic, may result in mobile cecum syndrome.
Owing to a redundant mesocolon, the cecum is free to twist on itself, thus resulting in an intermittent cecal torsion. There are reported cases of cecal volvulus, bascule, and intussusception.
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