Mobile cecum syndrome

Introduction

• Embryological anatomic variation. • Found in 10% of the population.• More common in females• 2% present as acute intestinal obstruction.• Floppy cecum/mobile cecum syndrome/

Recurrent cecocolic torsion.

Embyrology

• Normal – Cecocolic fixation by mesocolon in right paracolic gutter by 4 months of age.

• Improper cecal fixation to lateral wall.• variable length of mesocolon leaves cecum

and ascending colon redundant.• Funicular jackson membrane acts as a fulcrum

for twisting.

Clinical features

• Often present with features of IBS.• Right lower quadrant pain.• Colicky pain• Constipation• Diarrhea.• Abdominal distension.• Dyspareunia

Treatment

• Caecopexy with lateral peritoneal flap• Lateral cecocolopexy.• Cecocolopexy with appendicectomy• Resection of jackson membrane and

parietocolic bands that serve as fulcrum for twisting of the cecum.