Appendicular nodes

At a glance

English

Appendicular nodes

Latin (TA2)

Nodi appendiculares

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the appendicular nodes

The appendicular nodes lie in the mesoappendix, the small triangular fold of peritoneum that attaches the vermiform appendix to the mesentery of the terminal ileum. They are spaced along the appendicular artery, which runs in the free edge of this fold. They are few and small, and in many people they are absent altogether, in which case lymph from the appendix passes straight to the next nodes along the route.

They form the first link in the ileocolic chain. The appendicular artery is itself a branch of the ileocolic artery, and the nodes along it lead on to the ileocolic nodes near the caecum and terminal ileum, among them the precaecal and retrocaecal nodes.

Their afferent vessels come from the wall of the appendix, which is rich in lymphoid tissue, especially in children and young adults. Lymph leaving them passes to the ileocolic nodes and then along the ileocolic artery to the superior mesenteric nodes, from which it reaches the intestinal trunk.

Enlarged mesenteric nodes in this region are a common finding in children with abdominal pain. Mesenteric adenitis, often following a viral infection, can mimic appendicitis closely. In appendicitis the nearby nodes are often reactive and enlarged. Tumours of the appendix, such as neuroendocrine tumours, may spread along this route, which is why removal of the right colon with its ileocolic nodes is sometimes advised after one is found.

Course and drainage

Begins at

Afferent vessels from the wall of the vermiform appendix.

Drains into

Efferent vessels pass to the ileocolic nodes and on to the superior mesenteric nodes.

Drains

Filters lymph from the appendix. Reactive enlargement in this region accompanies appendicitis and mesenteric adenitis; tumours of the appendix spread along this route to the ileocolic nodes.