Mobile cecum syndrome

Five cases of mobile cecum syndrome are presented. These patients all presented with chronic right lower quadrant abdominal pain with associated abdominal distention and symptomatic relief after passing flatus or having a bowel movement. Three patients had preoperative barium enemas demonstrating abnormal mobility of the cecum. On exploration, all patients were found to have the cecum and ascending colon unattached to the lateral peritoneum for 15 to 18 cm. All patients were treated by cecopexy, using a lateral peritoneal flap for fixation, and all have had relief of their pain. This technique is described and illustrated. Cecopexy is an effective method of fixing the cecum and prevents subsequent cecal volvulus. The diagnosis of mobile cecum syndrome should be considered in patients with chronic right lower quadrant pain.