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Pediatrics
Diagnosis
Gastrointestinal
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

                            1. 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
                            2. Soffers JH et al: The growth pattern of the human intestine and its mesentery. BMC Dev Biol. 15:31, 2015
                            3. Metzger R et al: Embryology of the midgut. Semin Pediatr Surg. 20(3):145-51, 2011
                            4. Martin LC et al: Review of internal hernias: radiographic and clinical findings. AJR Am J Roentgenol. 186(3):703-17, 2006
                            5. 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
                            6. 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

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