Mega-Cecum with Short Intraperitoneal Ascending Colon and Retrocecal Terminal Ileum: A Short Review and Case Report

Abstract

The dissection of the abdominal cavity of an 81-year-old male donor revealed an unusually large cecum, filling the right iliac fossa and most part of the right side of the peritoneal cavity up to the fundus of the gall bladder. It was attached to the parietal peritoneum of the posterior abdominal wall by a short mesocecum. The ileocecal junction was shifted posterolaterally, closer to the posterolateral abdominal wall and the terminal ileum was found running from medial to lateral dorsal to the cecum (retrocecal) to reach the ileocecal junction. The cecum continued into a short intraperitoneal ascending colon with a long ascending mesocolon. The transitional area between the cecum and ascending colon was displaced medially close to the lumbar vertebral column. Since the ileocecal region is one of the common sites of different kinds of gastrointestinal diseases, such a complex variation can cause diagnostic and therapeutic difficulty that could result in failure of treatment as well as iatrogenic injuries during various procedures. Therefore, gastroenterologists, gastrointestinal surgeons and radiologists must be aware of such coexisting variations of the cecum, ileum and ascending colon.