Mobile Cecum: An Incidental Finding

Abstract

To hypothesize that mobile cecum is a rare etiological factor and cecopexy is the choice of treatment in patients with recurrent right lower abdominal pain. Prospective study was conducted in the department of general surgery, SSG Hospital, Baroda, from January 2008 to December 2009. Patients with recurrent right lower abdominal pain were planned for appendectomy. In those patients with intraoperative findings suggestive of macroscopically normal appendix while cecum found to be mobile and no other gross abnormality, appendectomy was performed with cecopexy, fixing cecum to lateral abdominal wall with polypropylene 3-0 suture in interrupted manner. Histopathological examination was confirmed in all the cases. A total of 110 patients complaining of recurrent right lower abdominal pain, with clinical and radiological findings suggestive of appendicitis, were planned for appendectomy. Of 110 patients, 20 were found to have macroscopically normal appearing appendix and of those 20 patients, 8 had cecum unattached to the lateral peritoneal wall. The rest of 90 patients had grossly inflamed appendix in which 10 patients had cecum unattached to the lateral peritoneal wall. Appendectomy and cecopexy were performed in all the patients. On histological examination of the excised appendices, of those 20 with macroscopically normal appearance, 11 had features suggestive of chronic appendicitis and remaining 9 patients were found to have normal histology. While the other 90 with grossly inflamed appendix showed pathological changes of acute inflammation. A total of 64 patients of 110 were followed up till date with no recurrence of abdominal pain. A mobile cecum should be considered a cause of recurrent right lower abdominal pain, and cecopexy is easy to perform and good treatment of choice for a mobile cecum.

Appendicitis in epigastric hernia: a rare case report

“…This is related to the anatomical position of the appendix of the developmental stage of the intestinal rotation. 8 After extensive research in the literature, only a citation of a case in Turkish magazine, 1965, without digitized version, of appendicitis in epigastric hernia was found.…”

“…In addition, the acute inflammatory response (appendicitis) and subsequent intra-abdominal events (localization, adhesion and abscess) and the presence of a previous (epigastric) defect could explain this presentation. 8 Another explanation in such circumstances is appendicitis as a result of extrinsic pressure, strangulation, and necrosis within the hernia defect.…”

Two sisters with a rare cause of infantile colic

“…However, when MCS is symptomatic, it predisposes to volvulus in 50% of cases . It is not clear what degree of detachment is enough to cause painful rotation …”

A rare presentation of an acute appendicitis

“…It has been suggested that in 10% of the population, there might be an anatomical variation and abnormal cecum mobility otherwise referred to as mobile cecum syndrome [5]. In such individuals, the lateral peritoneal attachment of cecum is either absent or so mobile that terminal ileum and cecum can be found in any quadrant of the abdomen depending on the position and activity of the patient [6]. In addition, acute inflammatory response (appendicitis) and subsequent intraabdominal events (localization, adhesion and abscess) and the presence of a prior defect (paraumbilical) could explain such presentation.…”