is the human cecums wall thinner then the other intestinal walls?

Question

I have a theory about something and need to find this out, is the human cecum area of the intestines, exterior wall thinner then the other walls of the intestines?

Answer 1

Yes, the cecum is the thinnest walled portion of the colon, and for that matter, of the entire abdominal gastrointestinal tract!

This has several direct effects on my practice as a surgeon.

1) In patients who are experiencing either colon obstruction or colon illness that involves large amounts of liquid and gas back-up, it is the cecum that is most in jeopardy. As per "Laplace's law" (look it up) the wall tension is proportional to radius and inversely proportional to wall thickness. Since the cecum is already thin and is already somewhat bulbous, it can blow up like a balloon until it bursts. We are therefore acutely vigilant about watching the size of the cecum on imaging studies, and intervening surgically as the size becomes dangerously large, (above 11 cm in diameter becomes worrisome).

2) When gastroenterologists do routine colonoscopy, they will take biopsies of anything that looks like a bump growing on the inside wall of the colon. These are called polyps. Polyps can be "pedunculated" meaning that they look almost like mushrooms, up on a stalk, or they can be "sessile" meaning that they look low and flat, more like an upside down dinner plate on a table. When a polyp can be completely removed with a snare using the colon scope, then we can be completely assured of a non-cancerous diagnosis when the pathologist tells us that they find no cancer in the specimen. However, when a specimen can only be partially removed, we have to be concerned that even if the pathologist tells us that they see no cancer, there may be cancer in the part that was left behind. For this reason, when a polyp cannot be removed with the scope, it has to be removed by us surgically. Gastroenterologists will frequently refer patients with sessile polyps in the cecum to surgeons. The wall of the cecum is thin enough that with a scope, there is a substantial likelihood that a snare wrapped around the whole polyp would cut right through the entire wall of the bowel and cause a leak. Since they can, at best, take a pinch of tissue as a specimen, these patients have incomplete removal and therefore require surgical excision. We typically perform a full right colectomy so that if there IS cancer, we don't have to go back and take more.

3) One of the most common emergency operations general surgeons do is to remove an inflammed appendix. I perform this operation laparoscopically, and I remove the appendix from the cecum with a surgical stapling device. It fires 4 rows of tiny staples and then slices down the middle, sealing off both sides and dividing at the same time. In order to insure that all of the appendix is gone, the staple line actually goes on the cecum, just beneath the base where the appendix attaches. There are multiple sizes of staples available for different surgical applications, and they differ primarily in how thin they compress the tissue once they have been fired. For thick tissue like stomach, there is a large size, for intestine there is a medium size, and for blood vessels (which obviously benefit from tight crimping if they are going to be divided) there is a narrower size. I typically use the narrower size on cecum, because the tissue is thin enough that I have concerns about the other sizes being loose enough for the cecum to actually leak. It's the only place in the GI tract that I would use this size staple.

I'm sure that this is more information than you were looking for, but it's a really interesting question! Not many non-surgeons would think such a thought, so I concluded you'd benefit from a surgeon's type of answer.

Answer 2

the cecum wall is not thinner than the rest of the bowels, its the same width,

Answer 3

LAPLASS low why the cecum will be perforated first in bowel obustruction
the redius is higher bingoo it was found many many years ago