The caecum is the blind-ended pouch at the start of the large intestine, lying in the right iliac fossa below the level of the ileocaecal junction. It is the widest part of the colon. It is usually covered by peritoneum and fairly mobile, and the vermiform appendix arises from its posteromedial wall where the three taeniae coli meet.
| Location | Right iliac fossa, below the ileocaecal junction, above the lateral half of the inguinal ligament |
|---|---|
| Parts |
|
| Nerve Supply | Vagus nerve (parasympathetic); Superior mesenteric plexus, from lesser splanchnic nerves (sympathetic) |
| Blood Supply | Anterior and posterior caecal arteries (from the ileocolic artery) |
| Venous drainage |
|
| Lymphatic drainage |
|
Receives contents from the ileum, absorbs water and salts and begins the bacterial fermentation of undigested material.
Because it has the widest diameter, the caecum feels the highest wall tension when the colon is obstructed (Laplace law) and is the usual site of perforation. Tumours here can grow large before causing symptoms and often present with iron deficiency anaemia. An unusually mobile caecum can twist (caecal volvulus).
Twisting of a mobile caecum and ascending colon on its mesentery, causing acute obstruction and risk of ischaemia.
Right-sided colon cancer that often presents with anaemia, fatigue or a mass rather than obstruction.
Inflammation and necrosis of the caecum in severely neutropenic patients, such as during chemotherapy (typhlitis).
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