Mobile cecum: an incidental finding

To hypothesize that mobile cecum is a rare etiological factor and cecopexy is the choice of treatment in patients with recurrent right lower abdominal pain. Prospective study was conducted in the department of general surgery, SSG Hospital, Baroda, from January 2008 to December 2009. Patients with recurrent right lower abdominal pain were planned for appendectomy. In those patients with intraoperative findings suggestive of macroscopically normal appendix while cecum found to be mobile and no other gross abnormality, appendectomy was performed with cecopexy, fixing cecum to lateral abdominal wall with polypropylene 3-0 suture in interrupted manner. Histopathological examination was confirmed in all the cases. A total of 110 patients complaining of recurrent right lower abdominal pain, with clinical and radiological findings suggestive of appendicitis, were planned for appendectomy. Of 110 patients, 20 were found to have macroscopically normal appearing appendix and of those 20 patients, 8 had cecum unattached to the lateral peritoneal wall. The rest of 90 patients had grossly inflamed appendix in which 10 patients had cecum unattached to the lateral peritoneal wall. Appendectomy and cecopexy were performed in all the patients. On histological examination of the excised appendices, of those 20 with macroscopically normal appearance, 11 had features suggestive of chronic appendicitis and remaining 9 patients were found to have normal histology. While the other 90 with grossly inflamed appendix showed pathological changes of acute inflammation. A total of 64 patients of 110 were followed up till date with no recurrence of abdominal pain. A mobile cecum should be considered a cause of recurrent right lower abdominal pain, and cecopexy is easy to perform and good treatment of choice for a mobile cecum.