The caecum (from the Latin cæcum intestinum, blind intestine) is an organ of the digestive tract. It corresponds to the first part of the colon, also called the large intestine.

Location. The cecum is located in the right iliac fossa at the level of the lower abdomen, and behind the anterior abdominal wall. (1)

Structure. Initial intestinal segment of the colon, the caecum follows the ileum, the last part of the small intestine. The mouth of the ileum at the caecum consists of an ileo-caecal valve as well as a thick sphincter and forms the ileo-caecal angle. Finishing in a cul-de-sac, the caecum is 6 to 8 cm wide. It has an atrophied extension below the orifice of the ileum, known as the vermicular appendix.

The cecum and the appendix are made up of 4 tunics, superficial layers:

• serosa, which forms the membrane on the outside and corresponds to the visceral peritoneum
• muscular, which is made up of longitudinal muscle bands
• submucosa
• mucous

Vascularization and innervation. The whole is vascularized by the cecal and appendicular arteries and innervated by the nerves originating from the solar plexus and superior mesenteric plexus.

Absorption of water and electrolytes. The main role of the cecum is to absorb water and electrolytes still present after digestion and absorption, carried out in the small intestine (2).

Barrier role. The ileocecal valve and sphincter usually help prevent material from returning to the ileum. This one-way barrier is essential to prevent contamination of the small intestine with bacteria present in the colon (3).

Typhlite. It corresponds to an inflammation of the cecum and is manifested by abdominal pain accompanied by diarrhea. This pathology most often appears in immunocompromised patients. (4)

Appendicitis. It results from inflammation of the appendix, manifests as severe pain and should be treated promptly.

Volvulus du Blind. It corresponds to a torsion of the cecum due to hypermobility of the latter. Symptoms may be abdominal pain and cramps, constipation, or vomiting.

Tumors. Colon cancers mainly arise from a benign tumor, called an adenomatous polyp, which can develop into a malignant tumor (4) (5). These tumors can in particular develop in cells of the inner wall of the cecum.

Medical treatment. Depending on the pathology, drug treatment may be prescribed such as analgesics, laxatives or even ointments.

Surgical treatment. Depending on the pathology and its progress, surgical treatment may be performed such as ablation of the colon (colectomy).

Chemotherapy, radiotherapy or targeted therapy. These are different types of treatments used to destroy cancer cells.

Physical examination. The onset of pain begins with a clinical examination to assess the characteristics of the pain and the accompanying symptoms.

Biological examination. Blood and stool tests may be done.

Medical imaging examination. Depending on the suspected or proven pathology, additional examinations may be performed such as ultrasound, a CT scan or an MRI.

Endoscopic examination. A colonoscopy may be done to study the walls of the colon.

The shape of the caecum is assimilated to a cul-de-sac, hence its Latin origin: caecum, blind bowel (6).