| Objective To study the diagnosis standard and clinical manifestationsof low position cecum and question its clinical value.Methods Three classification grades are made in 102 low position cecum patients according to the intestinal tract contrast examination and clinical manifestations: the cecum is in the pelvic canal but above the middle line of the pelvic canal ( rather the level of the bilateral superior border of caput femoris ) is I° ;the position of the cecum is between the middle line of the pelvic canal and the level of upper margin of pubic bone is II° ;the distal arcuation of the cecum reaches the anterior median line is III° ,the patients in each grade is 67,28 and 7 respectively. The patients are compared with the control group. Shimadz-1250mA gastrointestinal X-ray machine is performed in the study. The patients take the barium meal or have the barium enema to fill the ileocecum . observe the position of distal cecum in erect position ,then observe the upward movement of cecum ,the horizontal movement of the mobile cecum and the position of theappendix in dorsal position. 5 patients who were suspected as ileocecum tumor, received CT examination first, negative result ,then the barium enema examination followed confirmed the low position cecum . Pelvic cavity CT scan is performed to the III patients to observe the compressed appearance of bladder by the low position cecum. Results (1) the difference of still ptosed ratio in dorsal position betweenI° and II° or I° and III° is significant.(P<0.05) (2) the difference between I ptosis and control group is not significant.(P>0.05) (3) 8 patients have the tenesmus sense in right lower abdomen; 13 patients have constipation; 16 patients have abdominal distension;6 patients have diarrhea;3 patients have rectal tenesmus and 2 patients have transient high frequency of micturition. 30 patients have no digestive organic disease after the enteroscopy and image and other examinations in the 102 low position cecum patients, and the ratio of clinical symptoms in I° II° and HI ?ptosis is 6/67,17/28 and 7/7 respectively. (4) I° and II° ptosis both accompany some degree of mobile cecum, but mobile cecum can not be examined inII° (reach the level of the upper margin of pubic bone)and III ° ptosis,because the cecum has reached the inferior region of the pelvic canal. The mobile cecum in 11° and III° ptosis is not significant as that in I° ptosis. but II° and III° low position cecum can compress the organs in the pelvic cavity, and cause compression symptoms, especially in the ectatic cecum patients. (5) 42 patients' cecaare observed in the pelvic canal inthe pelvic canal in dorsal position in the 102 low position cecum patients and 8 appendixes are not development so the McBurney's point is examined in the other 34 patients in this study. The point is on the anterior median line and 2,3cm above the upper margin of pubic bone in 2 patients; 19 patients have the points in the area of 2~6cm right to the anterior median line and 5~8cm above the upper margin of pubic bone and 13 patients have the points in the area of l~5cm right to the anterior median line and l~4cm above the upper margin of pubic bone. All of them are under the normal McBurney' s point.Conclusion low position cecum is not rare in clinic, and always accompany some degree of clinical symptoms, in the low position ceca, II° or III°ptosis has clinical value.
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