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Normal Variations of Cecal Position
Steven J. Kraus, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Slight mobility of normally fixed cecum, allowing variation in normal cecal position
              • Various factors can affect cecal position
              • Clinical significance of cecal position
                • Often abnormal in malrotation
                  • If adjacent to duodenum, suggests short mesenteric pedicle → ↑ risk of midgut volvulus (whether or not duodenal malrotation present)
                • If completely air-filled, essentially excludes ileocolic intussusception in young child
                  • Best seen with left side down decubitus position
                • In evaluation for appendicitis, appendix location follows cecal position

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • Ultrasonographic Findings

                    • CT Findings

                      • MR Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              CLINICAL ISSUES

                              • Presentation

                                • Natural History & Prognosis

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    Selected References

                                    1. Soffers JH et al: The growth pattern of the human intestine and its mesentery. BMC Dev Biol. 15:31, 2015
                                    2. Metzger R et al: Embryology of the midgut. Semin Pediatr Surg. 20(3):145-51, 2011
                                    3. Martin LC et al: Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 186(3):703-17, 2006
                                    4. Fiorella DJ et al: Frequency of right lower quadrant position of the sigmoid colon in infants and young children. Radiology. 219(1):91-4, 2001
                                    5. Long FR et al: Radiographic patterns of intestinal malrotation in children. Radiographics. 16(3):547-56; discussion 556-60, 1996
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Clinical Issues

                                            • Diagnostic Checklist

                                              TERMINOLOGY

                                              • Definitions

                                                • Slight mobility of normally fixed cecum, allowing variation in normal cecal position
                                                • Various factors can affect cecal position
                                                • Clinical significance of cecal position
                                                  • Often abnormal in malrotation
                                                    • If adjacent to duodenum, suggests short mesenteric pedicle → ↑ risk of midgut volvulus (whether or not duodenal malrotation present)
                                                  • If completely air-filled, essentially excludes ileocolic intussusception in young child
                                                    • Best seen with left side down decubitus position
                                                  • In evaluation for appendicitis, appendix location follows cecal position

                                              IMAGING

                                              • General Features

                                                • Radiographic Findings

                                                  • Fluoroscopic Findings

                                                    • Ultrasonographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                CLINICAL ISSUES

                                                                • Presentation

                                                                  • Natural History & Prognosis

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      Selected References

                                                                      1. Soffers JH et al: The growth pattern of the human intestine and its mesentery. BMC Dev Biol. 15:31, 2015
                                                                      2. Metzger R et al: Embryology of the midgut. Semin Pediatr Surg. 20(3):145-51, 2011
                                                                      3. Martin LC et al: Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 186(3):703-17, 2006
                                                                      4. Fiorella DJ et al: Frequency of right lower quadrant position of the sigmoid colon in infants and young children. Radiology. 219(1):91-4, 2001
                                                                      5. Long FR et al: Radiographic patterns of intestinal malrotation in children. Radiographics. 16(3):547-56; discussion 556-60, 1996