[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) › Cecum [Digestive system](https://durgical.com/en/anatomy/system/digestive-system/) · [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) # Cecum The cecum is the pouch at the start of the large intestine, in the lower right belly, where the small intestine joins and the appendix hangs. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=abdomen&select=cecum&side=r) Opens in the Durgical app, no sign-up needed. ## What it is The pouch at the start of the large intestine, in the lower right [abdomen](https://durgical.com/en/anatomy/region/abdomen/), where the ileum enters through the ileocecal valve. ## What it does Receives intestinal contents from the ileum; the appendix hangs from it. ## Key points - Widest part of the colon with the thinnest wall: in a distal large-bowel obstruction with a competent ileocecal valve, it is the most likely place to perforate (law of Laplace) - Right-sided colon cancers often present with iron-deficiency anemia and weight loss rather than obstruction, because the lumen is wide and the contents are liquid - The commonest position of the appendix is behind it, in the retrocecal recess ## Key facts **Where** Right iliac fossa, blind pouch below ileocecal junction; usually intraperitoneal without its own mesentery **Blood supply** Anterior and posterior cecal branches of [ileocolic artery](https://durgical.com/en/anatomy/ileocolic-artery/) (SMA) **Nerve** [Superior mesenteric plexus](https://durgical.com/en/anatomy/superior-mesenteric-plexus/) (sympathetic and vagal); visceral pain referred to periumbilical region (T10) **Function** Receives ileal contents through ileocecal valve; absorbs water and salts; appendix opens on its posteromedial wall ## Relations **In front** Coils of [ileum](https://durgical.com/en/anatomy/ileum/), [greater omentum](https://durgical.com/en/anatomy/greater-omentum/) and the anterior abdominal wall of the right iliac fossa **Behind** [Iliacus](https://durgical.com/en/anatomy/iliacus-muscle/) and [psoas major](https://durgical.com/en/anatomy/psoas-major/), with the femoral and lateral femoral cutaneous nerves behind the parietal [peritoneum](https://durgical.com/en/anatomy/peritoneum/); the retrocecal recess **Medial** Terminal ileum entering at the ileocecal valve; the [appendix](https://durgical.com/en/anatomy/vermiform-appendix/) arises below and medial to it **Above** Continues as the [ascending colon](https://durgical.com/en/anatomy/ascending-colon/) above the level of the ileocecal junction **Lateral** Right paracolic gutter ## How to find it It projects onto the right iliac fossa, above the lateral half of the [inguinal ligament](https://durgical.com/en/anatomy/inguinal-ligament/). At colonoscopy, reaching it is confirmed by seeing the appendiceal orifice, the ileocecal valve and the converging taeniae (the «crow's foot»), sometimes with light shining through the right iliac fossa. ## On imaging On abdominal X-ray and CT a dilated cecum signals distal colonic obstruction or pseudo-obstruction. Cecal volvulus shows a large gas-filled loop often displaced to the upper left abdomen. ## Common problems - Colon polyps and colorectal cancer: screening finds them early. - Diverticular disease and diverticulitis (usually sigmoid). - Ulcerative colitis and Crohn disease. ## How it is diagnosed Colonoscopy; CT; stool tests for screening. ## Treatment - Polyps removed during colonoscopy; surgery (colectomy) for cancer or complicated disease. ## Clinical notes - Acute colonic pseudo-obstruction (Ogilvie syndrome) distends mainly the cecum - Neutropenic enterocolitis (typhlitis): cecal inflammation in patients with very low neutrophil counts, for example during chemotherapy - Ileocecal tuberculosis and amebic colitis favor this region, both relevant in Latin America - Pain from the cecum (midgut) is felt around the umbilicus until the overlying parietal peritoneum is involved ## Anatomical variants - A mobile cecum with its own mesentery in some people, which allows cecal volvulus - A high (subhepatic) cecum from incomplete descent, which moves appendicitis pain upward ## Development The cecum and appendix grow from the cecal bud on the caudal limb of the midgut loop; after the loop returns to the abdomen the cecum descends from below the [liver](https://durgical.com/en/anatomy/liver/) to the right iliac fossa. ## Related conditions - [Acute appendicitis](https://durgical.com/en/conditions/acute-appendicitis/) - [Colorectal cancer](https://durgical.com/en/conditions/colorectal-cancer/) - [Large bowel obstruction](https://durgical.com/en/conditions/large-bowel-obstruction/) - [Crohn disease](https://durgical.com/en/conditions/crohn-disease/) - [Intussusception (children)](https://durgical.com/en/conditions/intussusception/) - [Lynch syndrome (hereditary non-polyposis colorectal cancer)](https://durgical.com/en/conditions/lynch-syndrome/) - [Iron deficiency anaemia](https://durgical.com/en/conditions/iron-deficiency-anaemia/) - [Soil-transmitted helminthiasis (ascariasis, hookworm, trichuriasis)](https://durgical.com/en/conditions/soil-transmitted-helminthiasis/) - [Intestinal amoebiasis (amoebic dysentery)](https://durgical.com/en/conditions/intestinal-amoebiasis/) - [Necrotising enterocolitis](https://durgical.com/en/conditions/necrotising-enterocolitis/) ## Test yourself Think of the answer, then tap the question to see it. ## Why is the cecum the likeliest site of perforation in distal colonic obstruction? It is the widest part of the colon with the thinnest wall (law of Laplace), especially with a competent ileocecal valve. ## How do right-sided colon cancers in the cecum usually present? With iron-deficiency anemia and weight loss rather than obstruction, because the lumen is wide and the contents liquid. ## Which landmarks confirm the cecum is reached at colonoscopy? The appendiceal orifice, the ileocecal valve and the converging taeniae (the «crow's foot»). [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/cecum/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** caecum; papilla ilealis TA2 2970 **Official Spanish (DeCS)** Ciego DeCS D002432 **English (TA2)** Cecum **Also called** ileocecal valve · intestinum caecum ## Related - [Ileum](https://durgical.com/en/anatomy/ileum/) - [Appendix](https://durgical.com/en/anatomy/vermiform-appendix/) - [Ascending colon](https://durgical.com/en/anatomy/ascending-colon/) - [Ileocolic artery](https://durgical.com/en/anatomy/ileocolic-artery/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=2468); [Anatomy, Abdomen and Pelvis: Large Intestine](https://www.ncbi.nlm.nih.gov/books/NBK470577/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/cecum/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/cecum/