1160 



SPLANCHNOLOGY 





Anterior 

 Superior ileocecal 

 ileocecal artery 

 fold 



Mesentery 



Superior 



ileocecal 



fossa 



Inferior 

 ileocecal 



fold 

 Ileum 



fossa?; it can be seen by pulling the jejunum downward and to the right, after the 

 transverse colon has been pulled upward. It is bounded above by the pancreas, 

 to the right by the aorta, and to the left by the kidney; beneath is the left renal 

 vein. It has a depth of from 2 to 3 cm., and its orifice, directed downward and to 

 the right, is nearly circular and will admit the tip of the little finger. 



2. Cecal Fossse (pericecal folds or fosses). There are three principal pouches 

 or recesses in the neighborhood of the cecum (Figs. 1043 to 1045) : (a) The superior 

 ileocecal fossa is formed by a fold of peritoneum, arching over the branch of the 

 ileocolic artery which supplies the ileocolic junction. The fossa is a narrow chink 

 situated between the mesentery of the small intestine, the ileum, and the small 

 portion of the cecum behind. (6) The inferior ileocecal fossa is situated behind the 

 angle of junction of the ileum and cecum. It is formed by the ileocecal fold of 

 peritoneum (bloodless fold of Trews), the upper border of which is fixed to the ileum, 



opposite its mesenteric attach- 

 ment, while the lower border, 

 passing over the ileocecal junc- 

 tion, joins the mesenteriole of the 

 vermiform process, and some- 

 times the process itself. Between 

 this fold and the mesenteriole 

 of the vermiform process is the 

 inferior ileocecal fossa. It is 

 bounded above by the posterior 

 surface of the ileum and the me- 

 sentery; in front and below by the 

 ileocecal fold, and behind by the 

 upper part of the mesenteriole 

 of the vermiform process, (c) 

 The cecal fossa is situated im- 

 mediately behind the cecum, 

 which has to be raised to bring 

 it into view. It varies much in 

 size and extent. In some cases 



it is sufficiently large to admit the index finger, and extends upward behind the 

 ascending colon in the direction of the kidney; in others it is merely a shallow 



Inferior 

 ileocecal fossa 



Mesentery 



\ Artery to 



) vermiform 'process 



Mesenteriole of 

 vermiform process 



FIG. 1044. Inferior ileocecal fossa. The cecum and ascending colon have been drawn lateralward and downward, 

 the ileum upward and backward, and the vermiform process downward. (Poirier and Charpy.) 



depression. It is bounded on the right by the cecal fold, which is attached by 

 one edge to the abdominal wall from the lower border of the kidney to the iliac 



FIG. 1043. Superior ileocecal fossa. (Poirier and Charpy.) 



