Precaecal nodes

At a glance

English

Precaecal nodes

Latin (TA2)

Nodi precaecales

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the precaecal nodes

The precaecal nodes are a small subgroup of the ileocolic nodes, which drain the region where the small intestine joins the large. They follow the anterior caecal artery, a branch of the ileocolic artery that passes over the front of the ileocaecal junction to the anterior surface of the caecum. A partner group, the retrocaecal nodes, follows the posterior caecal artery behind it.

The artery and its nodes run in the vascular fold of the caecum, a small peritoneal fold raised by the vessel in front of the terminal ileum. The fold bounds the superior ileocaecal recess, a small pocket of peritoneum. The caecum itself lies in the right iliac fossa, usually free and covered by peritoneum, with the appendix arising from its lower posteromedial wall.

Lymph enters these nodes from the front of the caecum and the adjacent part of the ascending colon. It then passes upward to the main ileocolic nodes along the ileocolic artery and from there to the superior mesenteric nodes, the intestinal trunk and the cisterna chyli.

Swollen nodes in this corner are common in children with viral illnesses and can give pain in the right lower abdomen that is easily mistaken for appendicitis. Cancer of the caecum may spread first to these and the other ileocolic nodes, so a right hemicolectomy takes the ileocolic artery and its nodes with the bowel.

Course and drainage

Begins at

Afferent vessels from the anterior wall of the caecum and the start of the ascending colon.

Drains into

Efferent vessels pass to the ileocolic nodes along the ileocolic artery, then to the superior mesenteric nodes.

Drains

Filters lymph from the front of the caecum. Enlargement can mimic appendicitis, and the nodes are an early station for caecal cancer, removed in a right hemicolectomy.