Caecum

The caecum begins right after a small intestine and represents initial department of a large intestine. It is located right after the ileocecal valve interfering the return hit of intestinal contents from a large intestine in thin.

Caecum structure

By the outward the caecum reminds a bag and is located in the field of the right ileal pole. Its front part is covered with the epiploon separating it from an abdominal wall. In a caecum there is a sphincter which is on border between a caecum and a worm-shaped shoot (an appendix, a caecum shoot). It plays a role of the valve and interferes with hit of a chyme (the liquid intestinal contents consisting of partially digested food, gastric and intestinal juices) in a gleam of a worm-shaped shoot and is called Gerlakh's valve.

Caecum shoot

The caecum shoot departs from a back wall of a caecum below the place of its connection with an ileal gut. Its length makes from 3 to 15 cm, and diameter usually does not exceed 5 mm. He usually lies down in the field of the right ileal pole. The appendix connects to a caecum a mesentery. In it the mucous membrane in which there are rather big sites of accumulation of an adenoid tissue covers.

It is considered that the shoot of a caecum is peculiar "incubator" in which microorganisms, necessary for normal function of intestines, develop. Is well-known such fact that after surgical removal of an appendix, intestinal microflora at people after treatment by antibiotics is recovered much longer, than at people at whom the shoot of a caecum is kept. In addition the appendix performs also protective function, being a part of system of mukazalny immunity. Therefore it is called sometimes an intestinal almond.

Caecum diseases

The caecum is the favourite place of localization of rather large number of various diseases that is explained by anatomic and physiological features of this department of intestines.

Caecum inflammation

Inflammatory process in fabrics of a caecum is called a typhlitis. In the symptoms the inflammation of a caecum is similar to appendicitis. Patients show complaints to the pains which are localized in the right ileal area. But if at appendicitis of pain are not connected with meal, then at a typhlitis they arise or amplify several hours later after food. In addition at a caecum inflammation at patients fervescence is noted, there are nausea, vomiting, diarrhea.

At a typhlitis it is necessary to carry out differential diagnosis with gynecologic diseases and appendicitis.

If the doctor establishes that inflammatory process is precisely localized in a caecum – treatment in this case conservative. To the patient usually appoint antibiotics of a broad spectrum of activity, carry out infusional therapy, appoint a bed rest and a sparing diet.

The typhlitis can lead to development of complications – a mesadenitis, a paratyphlitis (an inflammation of the fabrics surrounding a caecum) – treatment of which can demand carrying out surgical intervention.

Caecum cancer

Malignant tumors of a caecum make nearly 40% of all other tumors of intestines. Insidiousness of cancer of a caecum is that the disease at early stages proves nothing. Usually very first sign is emergence in the fecal mass of blood. The constant loss of blood gradually leads to development of the expressed anemia. Emergence of blood in fecal masses can be also observed at hemorrhoids. Therefore patients need additional inspection which allows to establish the exact diagnosis. All persons need to carry out the inspection directed to detection of cancer of a caecum also with the general anemia if the reason of its development is not established.

At later stages of cancer of a caecum patients begin to complain of pains in the right ileal area, on lack of appetite, weight loss. At metastasises mechanical jaundice develops in a liver.

In the presence of a malignant tumor of a caecum – treatment surgical. During operation make removal of an affected area of intestines. In most cases this operation does not demand imposing of a kolostoma (formation of an unnatural anal orifice necessary for removal of gas and fecal masses). Such need can arise only in extreme cases when operation is carried out at late stages of a disease, and it is followed by massive bleeding. During operation delete the lymph nodes and other soft tissues which are also affected by tumoral process.

After operation appoint beam and/or chemotherapy which reduce probability of a recurrence of a disease. If it is not possible to execute radical operation for any reasons (prevalence of process with existence of the remote metastasises, the general serious condition of the patient, extreme degree of exhaustion, etc.), then appoint chemotherapy which purpose is extension of life of the patient and improvement of its quality.

At malignant tumors of a caecum treatment is most effective at early stages of a disease and allows to achieve an absolute recovery in many cases. Therefore it is very important to ask at emergence of the first symptoms of cancer of a caecum for medical care!