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Normal Pediatric Variants
Normal Variations of Cecal Position
Normal Variations of Cecal Position
Steven J. Kraus, MD
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Diagnostic Checklist
TERMINOLOGY
Definitions
Slight mobility of fixed cecum, allowing variation in position
Various factors can affect cecal position
Clinical significance of cecal position
Often abnormal in malrotation
If adjacent to duodenum → short mesenteric pedicle → ↑ risk of midgut volvulus (whether or not duodenal malrotation is present)
If completely air-filled, excludes ileocolic intussusception
Best seen on left side down decubitus position
In imaging for appendicitis, appendix follows cecal position
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
US/CT/MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Selected References
Wozniak S et al: The large intestine from fetal period to adulthood and its impact on the course of colonoscopy. Ann Anat. 224:17-22, 2019
Soffers JH et al: The growth pattern of the human intestine and its mesentery. BMC Dev Biol. 15:31, 2015
Metzger R et al: Embryology of the midgut. Semin Pediatr Surg. 20(3):145-51, 2011
Martin LC et al: Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 186(3):703-17, 2006
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
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
Diagnostic Checklist
TERMINOLOGY
Definitions
Slight mobility of fixed cecum, allowing variation in position
Various factors can affect cecal position
Clinical significance of cecal position
Often abnormal in malrotation
If adjacent to duodenum → short mesenteric pedicle → ↑ risk of midgut volvulus (whether or not duodenal malrotation is present)
If completely air-filled, excludes ileocolic intussusception
Best seen on left side down decubitus position
In imaging for appendicitis, appendix follows cecal position
IMAGING
General Features
Radiographic Findings
Fluoroscopic Findings
US/CT/MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Selected References
Wozniak S et al: The large intestine from fetal period to adulthood and its impact on the course of colonoscopy. Ann Anat. 224:17-22, 2019
Soffers JH et al: The growth pattern of the human intestine and its mesentery. BMC Dev Biol. 15:31, 2015
Metzger R et al: Embryology of the midgut. Semin Pediatr Surg. 20(3):145-51, 2011
Martin LC et al: Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 186(3):703-17, 2006
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
Long FR et al: Radiographic patterns of intestinal malrotation in children. Radiographics. 16(3):547-56; discussion 556-60, 1996
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