# Cecum

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{{short description|Pouch in the large intestine}}
{{Redirect|Caecum|the genus of sea snails|Caecum (genus)|other taxonomic uses|List of Latin and Greek words commonly used in systematic names}}
{{Distinguish|sacrum}}

{{Infobox anatomy
| Name        = Cecum
| Latin       = caecum
| Image       = Tractus intestinalis cecum.svg
| Caption     = The cecum, here in red, lies at the start of the large intestine, which is shown with the rest of the human gastrointestinal tract in this image.
| Width       = 
| Image2      = Gray1043.png
| Caption2    = Superior ileocecal fossa<br />(cecum labeled at bottom left)
| Precursor   = [Midgut](/source/Midgut)
| System      = [Gastrointestinal](/source/Human_gastrointestinal_tract)
| Artery      = 
| Vein        = 
| Nerve       = 
| Lymph       = 
| PartOf      = [Large intestine](/source/Large_intestine)
| Location    = Lower right part of the abdomen
}}

The '''cecum''' ({{small|[UK](/source/British_English):}} '''caecum''', {{small|pronounced}} {{IPAc-en|ˈ|s|iː|.|k|əm}}; plural '''ceca''' or {{small|[UK](/source/British_English):}} '''caeca''', {{small|pronounced}} {{IPAc-en|ˈ|s|iː|.|k|ə}}) is a pouch within the [peritoneum](/source/peritoneum) that is considered to be the beginning of the [large intestine](/source/large_intestine).<ref name="Stedman 2000 p. ">{{cite book |last=Stedman |first=Thomas |title=Stedman's medical dictionary |publisher=Lippincott Williams & Wilkins |publication-place=Philadelphia |year=2000 |isbn=978-0-683-40007-6 |oclc=42772946 |page=915 |quote='''large i[ntestine]''', the portion of the digestive tube extending from the ileocecal valve to the anus; it comprises the cecum, colon, rectum, and anal canal}}</ref> It is typically located on the right side of the body (the same side of the body as the [appendix](/source/appendix_(anatomy)), to which it is joined). The term stems from the [Latin](/source/Latin) ''caecus'', meaning "[blind](/source/blindness)".

It receives [chyme](/source/chyme) from the [ileum](/source/ileum), and connects to the [ascending colon](/source/ascending_colon) of the [large intestine](/source/large_intestine). It is separated from the ileum by the [ileocecal valve](/source/ileocecal_valve) (ICV), also called Bauhin's valve. It is also separated from the [colon](/source/Large_intestine) by the cecocolic junction. While the cecum is usually intraperitoneal, the ascending colon is [retroperitoneal](/source/Retroperitoneal_space).<ref>{{cite web |url=https://download.videohelp.com/vitualis/med/large_intestine.htm |title=The Large Intestine |publisher=VideoHelp.com}}</ref>

In [herbivore](/source/herbivore)s, the cecum stores food material where bacteria are able to break down the [cellulose](/source/cellulose). In humans, the cecum is involved in absorption of [salts](/source/salt_(chemistry)) and [electrolyte](/source/electrolyte)s and lubricates the solid waste that passes into the large intestine.<ref>{{Cite web |url=https://www.sciencing.com/functions-cecum-6809336/ |title=What Are the Functions of the Cecum?}}</ref>

==Structure==
thumb|Inner diameters of different sections of the large intestine, with cecum (at bottom left) measuring on average 8.7 cm (range 8.0-10.5 cm).<ref name=Nguyen>{{cite journal |vauthors=Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, Krouse R, Payne CM, Tsikitis VL, Goldschmid S, Banerjee B, Perini RF, Bernstein C |title=Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer |journal=J Vis Exp |issue=41 |year=2010 |pmid=20689513 |pmc=3149991 |doi=10.3791/1931 }}</ref>

===Development===
The cecum and appendix are derived from the bud of cecum that forms during week six in the midgut next to the apex of the umbilical herniation.<ref name="lie">{{cite journal |last1=Kostouros |first1=Antonios |last2=Koliarakis |first2=Ioannis |last3=Natsis |first3=Konstantinos |last4=Spandidos |first4=Demetrios |last5=Tsatsakis |first5=Aristidis |last6=Tsiaoussis |first6=John |title=Large intestine embryogenesis: Molecular pathways and related disorders (Review) |journal=International Journal of Molecular Medicine |date=21 April 2020 |volume=46 |issue=1 |pages=27–57 |doi=10.3892/ijmm.2020.4583 |pmid=32319546 |pmc=7255481 }}</ref> Specifically, the cecum and appendix are formed by the enlargement of the postarterial segment of the midgut loop.  The proximal part of the bud grows rapidly to form the cecum. The lateral wall of the cecum grows much more rapidly than the medial wall, with the result that the point of attachment of the [appendix](/source/appendix_(anatomy)) comes to lie on the medial side.{{Citation needed|date=May 2011}} The cecum's position changes after the midgut rotates and the ascending colon elongates, and the accumulation of meconium inside the cecum may result in the latter's increased diameter.<ref name="lie"/>

==History==
===Etymology===
The term ''cecum'' comes from Latin ''(intestinum) caecum'', literally 'blind intestine', in the sense 'blind gut' or '[cul de sac](/source/cul_de_sac)'.<ref>{{Cite web |title=Caecum - Etymology, Origin, and Meaning |url=https://www.etymonline.com/word/caecum |access-date=2022-05-27 |website=etymonline.com |language=en}}</ref> It is a direct translation from Ancient Greek {{lang|grc|τυφλὸν}} ({{lang|grc|ἔντερον}}) {{transliteration|grc|typhlòn}} ({{transliteration|grc|énteron}}). Thus the inflammation of the cecum is called typhlitis.

In [dissection](/source/dissection)s by the [Greek](/source/Ancient_Greece) [philosophers](/source/Greek_philosophy), the connection between the [ileum](/source/ileum) of the [small intestine](/source/small_intestine) and the cecum was not fully understood. Most of the studies of the [digestive tract](/source/Gastrointestinal_tract) were done on animals and the results were compared to human [structures](/source/human_anatomy).<ref>{{Cite web |title=Ileum |url=https://www.kenhub.com/en/library/anatomy/the-ileum |access-date=2022-06-18 |website=Kenhub |language=en}}</ref>

The junction between the small intestine and the colon, called the [ileocecal valve](/source/ileocecal_valve), is so small in some animals that it was not considered to be a connection between the small and large intestines. During a dissection, the colon could be traced from the [rectum](/source/rectum), to the [sigmoid colon](/source/sigmoid_colon), through the [descending](/source/descending_colon), [transverse](/source/transverse_colon), and [ascending](/source/ascending_colon) sections. The cecum is an end point for the colon with a dead-end portion terminating with the [appendix](/source/appendix_(anatomy)).<ref>{{cite web |last1=Taylor |first1=Tim |title=Anatomy and Physiology Instructor |url=https://www.innerbody.com/image/dige08.html |website=InnerBody.com |publisher=Howtomedia, Inc. |access-date=28 November 2014}}</ref>

The connection between the end of the small intestine (ileum) and the start (as viewed from the perspective of food being processed) of the colon (cecum) is now clearly understood, and is called the ileocecal orifice. The connection between the end of the cecum and the beginning of the ascending colon is called the cecocolic orifice.

==Clinical significance==
A cecal carcinoid tumor is a [carcinoid tumor](/source/carcinoid_tumor) of the cecum. An [appendiceal carcinoid tumor](/source/appendiceal_carcinoid_tumor) (a carcinoid tumor of the appendix) is sometimes found next to a cecal carcinoid.<ref>{{Cite journal |last1=Salirrosas Roncal |first1=Oscar A |last2=Tantalean Gutierrez |first2=Christian |last3=Llerena Vasquez |first3=Cesar |title=Carcinoid Tumor of the Cecal Appendix |journal=Cureus |date=2022 |volume=14 |issue=10 |article-number=e30793 |doi=10.7759/cureus.30793 |doi-access=free |issn=2168-8184 |pmc=9701446 |pmid=36447686}}</ref>

[Neutropenic enterocolitis](/source/Neutropenic_enterocolitis) (typhlitis) is the condition of inflammation of the cecum, primarily caused by bacterial infections.

Over 99% of the bacteria in the gut are [anaerobe](/source/anaerobe)s<ref name="Guarner and Malagelada 2003b">{{cite journal |author=Guarner F, Malagelada JR |title=Gut flora in health and disease |journal=Lancet |volume=361 |issue=9356 |pages=512–19 |date=February 2003 |pmid=12583961 |doi=10.1016/S0140-6736(03)12489-0 |s2cid=38767655}}</ref><ref name=Sears>{{cite journal |author=Sears CL |title=A dynamic partnership: celebrating our gut flora |journal=Anaerobe |volume=11 |issue=5 |pages=247–51 |date=October 2005 |pmid=16701579 |doi=10.1016/j.anaerobe.2005.05.001}}</ref><ref name="University of Glasgow">University of Glasgow. 2005. [https://web.archive.org/web/20040526195616/http://www.gla.ac.uk/departments/humannutrition/students/resources/meden/Infection.pdf The normal gut flora.] Available through web archive. Accessed May 22, 2008</ref><ref name="Beaugerie L and Petit JC">{{cite journal |author=Beaugerie L, Petit JC |title=Microbial-gut interactions in health and disease. Antibiotic-associated diarrhoea |journal=Best Pract Res Clin Gastroenterol |volume=18 |issue=2 |pages=337–52 |date=April 2004 |pmid=15123074 |doi=10.1016/j.bpg.2003.10.002}}</ref><ref name=Vedantam>{{cite journal |author=Vedantam G, Hecht DW |title=Antibiotics and anaerobes of gut origin |journal=Curr. Opin. Microbiol. |volume=6 |issue=5 |pages=457–61 |date=October 2003 |pmid=14572537 |doi=10.1016/j.mib.2003.09.006}}</ref> but, in the cecum, [aerobic bacteria](/source/aerobic_bacteria) reach high densities.<ref name="Prescotts">{{cite book |last2=Willey |first2=Joanne |last1=Sherwood |first1=Linda |last3=Woolverton |first3=Christopher |title=Prescott's Microbiology |url={{google books |plainurl=y |id=sBCSRAAACAAJ}} |year=2013 |isbn=978-0-07-340240-6 |publisher=McGraw Hill |location=New York |edition=9th |pages=713–21 |oclc=886600661}}</ref>

==Other animals==
[[File:Gastric caeca of dissected cockroach.tiff|thumb|Gastric cecum of dissected [cockroach](/source/cockroach). Scale bar, 2 mm.]]

A cecum is present in most [amniote](/source/amniote) species, and also in [lungfish](/source/lungfish), but not in any living species of [amphibian](/source/amphibian). In [reptile](/source/reptile)s, it is usually a single median structure, arising from the dorsal side of the large intestine. The ceca in [bird](/source/bird)s are often paired, with many exceptions; parrots, for example, do not have ceca, while others may have a single cecum or even two pairs, like the [secretarybird](/source/secretarybird).<ref name=MP>{{cite journal |last1=Clench |first1=Mary H. |last2=Mathias |first2=John R. |title=The Avian Cecum: A Review |journal=The Wilson Bulletin |date=1995 |volume=107 |issue=1 |pages=93–121 |id={{Gale|A16787963}} {{INIST|3480481}} |jstor=4163516}}</ref>

Most mammalian [herbivore](/source/herbivore)s have a relatively large cecum. In many species, it is considerably wider than the colon. For some herbivores such as [lagomorphs](/source/lagomorpha) (rabbits, hares, pikas), easily digestible food is processed in the gastrointestinal tract and expelled as regular feces. But in order to get nutrients out of hard-to-digest fiber, lagomorphs ferment fiber in the cecum and then expel the contents as [cecotrope](/source/cecotrope)s, which are reingested (cecotrophy). The cecotropes are then absorbed in the small intestine to utilize the nutrients.

In contrast, obligate [carnivore](/source/carnivore)s, whose diets contain little or no plant matter, have a reduced cecum, which is often partially or wholly replaced by the [appendix](/source/appendix_(anatomy)).<ref name=VB/> Mammalian species which do not develop a cecum include [raccoon](/source/raccoon)s,<ref>{{cite journal |last1=Clemens |first1=Edgar T. |last2=Stevens |first2=Charles E. |title=Sites of Organic Acid Production and Patterns of Digesta Movement in the Gastro-Intestinal Tract of the Raccoon |journal=The Journal of Nutrition |date=1 June 1979 |volume=109 |issue=6 |pages=1110–1116 |doi=10.1093/jn/109.6.1110 |pmid=448450 |url=https://www.sciencedirect.com/science/article/abs/pii/S0022316623277147 |access-date=1 June 2024 |issn=0022-3166 |url-access=subscription}}</ref> [bear](/source/bear)s,<ref>{{cite journal |last1=Jones |first1=James D. |last2=Zollman |first2=Paul E. |title=Black Bear (Ursus americanus) Bile Composition: Seasonal Changes |journal=Comparative Biochemistry and Physiology Part C: Pharmacology, Toxicology and Endocrinology |date=17 March 1997 |volume=118 |issue=3 |pages=387–390 |doi=10.1016/S0742-8413(97)00176-X |pmid=9467890 |url=https://www.sciencedirect.com/science/article/abs/pii/S074284139700176X |access-date=1 June 2024 |url-access=subscription}}</ref> and the [red panda](/source/red_panda).<ref>{{cite journal |last1=Wei |first1=F. |last2=Feng |first2=Z. |last3=Wang |first3=Z. |last4=Zhou |first4=A. |last5=Hu |first5=J. |title=Nutrient and energy requirements of red panda (Ailurus fulgens) during lactation |journal=Mamm |date=1 January 1999 |volume=63 |issue=1 |pages=3–10 |doi=10.1515/mamm.1999.63.1.3 |url=https://www.degruyterbrill.com/document/doi/10.1515/mamm.1999.63.1.3/html |access-date=1 June 2024 |language=en |issn=1864-1547 |url-access=subscription}}</ref> [Hyrax](/source/Hyrax)es, unlike other mammals, have two paired ceca.<ref name=VB>{{cite book |last1=Romer |first1=Alfred Sherwood |last2=Parsons |first2=Thomas S. |year=1977 |title=The Vertebrate Body |publisher=Holt-Saunders International |location=Philadelphia |pages=353–54 |isbn=978-0-03-910284-5}}</ref>

Many fish have a number of small outpockets, called ''pyloric ceca'', along their intestine; despite the name, they are not [homologous](/source/homology_(biology)) with the cecum of amniotes – their function is to increase the overall area of the digestive epithelium.<ref name=VB/> Some invertebrates, such as squid,<ref name=Williams1910>{{cite book |last1=Williams |first1=Leonard Worcester |title=The anatomy of the common squid: ''Loligo pealii'', Lesueur |date=1910 |doi=10.5962/bhl.title.27291 |oclc=697639284 |url=https://www.biodiversitylibrary.org/item/69772}}</ref> may also have structures with the same name, but these have no relationship with those of vertebrates.

==Gallery==
<gallery>
File:Blausen 0604 LargeIntestine2.png|Illustration of the large intestine
File:Monogastric Digestive System.webp|Illustration of human and rabbit cecum
File:Cecum and ileum.JPG|Cecum and ileum
File:Ileo-cecal valve.JPG|Ileo-cecal valve
File:Cecum and ileocecal valve.JPG|Cecum
File:Gray536.png|Arteries of cecum and [vermiform process](/source/Appendix_(anatomy))
File:Gray1044.png|Inferior ileocecal fossa
File:Ileocecal valve.jpg|[Endoscopic](/source/Colonoscopy) image of cecum with arrow pointing to [ileocecal valve](/source/ileocecal_valve) in foreground
</gallery>

==See also==
* [McBurney's point](/source/McBurney's_point)

==References==
{{Reflist}}

==External links==
{{Commons category|Cecum}}
{{Wiktionary|cecum}}
* {{SUNYAnatomyFigs|37|03|08}}—"Abdominal organs in situ"
* {{SUNYAnatomyFigs|37|06|09}}—"The larger intestine"
* {{SUNYAnatomyFigs|39|05|09}}—"The cecum with the distal portion of the ileum"
* {{SUNYAnatomyLabs|39|14|01|01}}—"Incisions of the Cecum"
* {{ViennaCrossSection|pelvis/pelvis-e12-2}}
* [https://web.archive.org/web/20060715020910/http://learning.mgccc.cc.ms.us/science/cat/sld021.htm Photo at mgccc.cc.ms.us]
* {{Webarchive |title=Video clip of worms in the Cecum - N Engl J Med 2006;354(13):e12 |url=https://web.archive.org/web/20100129103841/http://content.nejm.org/cgi/content/full/354/13/e12/DC1 |date=2010-01-29}} (Supplement to {{doi|10.1056/NEJMicm040931}})

{{Gastrointestinal tract}}
{{Authority control}}

Category:Digestive system
Category:Latin words and phrases

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Adapted from the Wikipedia article [Cecum](https://en.wikipedia.org/wiki/Cecum) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Cecum?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.