The ascending colon runs up the right side of the abdomen from the caecum to the right colic flexure under the liver, a length of about 12-15 cm. It is usually fused to the posterior abdominal wall and covered by peritoneum only on its front and sides. The right paracolic gutter lies along its outer side.
| Location | Right side of the abdomen, from the caecum to the right colic flexure, in front of the iliacus, quadratus lumborum and right kidney |
|---|---|
| Parts |
|
| Nerve Supply | Vagus nerve (parasympathetic); Superior mesenteric plexus, from lesser splanchnic nerves (sympathetic) |
| Blood Supply | Ileocolic artery (colic branch); Right colic artery |
| Venous drainage |
|
| Lymphatic drainage |
|
Absorbs water and electrolytes and moves contents upward toward the transverse colon.
Surgeons mobilise it by dividing the peritoneum along its lateral edge (the white line of Toldt) during right hemicolectomy. Angiodysplasia, a common cause of bleeding in older people, is found most often in the caecum and ascending colon. Cancers here usually present with anaemia rather than a change in bowel habit because the stool is still liquid.
Adenocarcinoma of the caecum or ascending colon that often presents with iron deficiency anaemia, weight loss or a right-sided mass.
Fragile dilated vessels in the colonic wall, typically on the right side in older adults, causing recurrent bleeding or anaemia.
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