Retrocaecal nodes

At a glance

English

Retrocaecal nodes

Latin (TA2)

Nodi retrocaecales

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the retrocaecal nodes

The retrocaecal nodes are a subgroup of the ileocolic nodes, the nodes serving the junction of the small and large intestine. They follow the posterior caecal artery, a branch of the ileocolic artery that passes behind the ileocaecal junction to the back of the caecum. Their partners in front, the precaecal nodes, follow the anterior caecal artery.

The caecum lies in the right iliac fossa on iliacus and psoas major, usually covered by peritoneum on all sides. Behind it a small pocket of peritoneum, the retrocaecal recess, often holds the appendix, which in many people lies tucked up behind the caecum. The retrocaecal nodes sit in this region, between the back of the caecum and the posterior abdominal wall.

Lymph reaches them from the posterior wall of the caecum and, in part, from the appendix, whose own nodes in its mesentery also drain this way. The efferent vessels pass to the main ileocolic nodes along the ileocolic artery, then to the superior mesenteric nodes, the intestinal trunk and the cisterna chyli.

These nodes may swell in appendicitis, in viral mesenteric adenitis in children, and in infections of the terminal ileum, so they are often seen on scans of right lower abdominal pain. Cancer of the caecum or appendix can spread to them first, and they are removed together with the ileocolic vessels in a right hemicolectomy.

Course and drainage

Begins at

Afferent vessels from the posterior wall of the caecum and partly from the appendix.

Drains into

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

Drains

Filters lymph from the back of the caecum and the appendix. They enlarge in appendicitis and mesenteric adenitis and are an early station for caecal and appendix cancers.