Cecum marks the beginning of the large intestine. It is a blind pouch that lies below the level of the junction of ileum with the large intestine. It is situated in the right iliac fossa and is completely covered with peritoneum (intraperitoneal organ). The length of cecum is about two and half inches. Although, it doesn’t have a mesentery, it possesses a considerable degree of mobility.
In the vicinity of cecum, there are peritoneal folds, which create three important recesses: Superior ileocecal recess, Inferior ileocecal recess and Retrocecal recess.
The longitudinal muscle in the cecum is restricted to three flat bands, known as teniae coli. The arrangement is similar to that of colon (the next part of large intestine). These bands of longitudinal muscle converge on the base of the appendix, which is attached to the posteromedial surface of cecum, and provide a complete longitudinal muscle coat for it.
The cecum is often distended with gas and in this condition; it can be palpated through the anterior abdominal wall in the living patients.
The terminal part of the ileum joins the large intestine at the ileocecal junction. The junction between the cecum and ascending colon also exists at the same level. The ileocecal junction is provided with two folds or lips, which form the ileocecal valve.
Relations of cecum:
- Coils of small intestine
- Part of the greater omentum (sometimes)
- Anterior abdominal wall of right iliac region
- Psoas and Iliacus muscles
- Femoral nerve
- Lateral cutaneous nerve of thigh
- Appendix (most commonly found in this position but may have other positions)
Blood supply of cecum:
The cecum receives its blood supply from the anterior and posterior cecal arteries. These arise from the ileocolic artery, which itself is a branch of the superior mesenteric artery.
The veins correspond to the arteries and eventually drain into the superior mesenteric vein.
Lymph drainage of cecum:
The lymphatics pass through several intermediate mesenteric nodes and eventually reach the superior mesenteric nodes.
Nerve supply of cecum:
Cecum receives both sympathetic and parasympathetic fibers from the superior mesenteric plexus.