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Posterior cecal artery

The posterior cecal artery is a small but important terminal branch of the ileocolic artery, supplying the posterior aspect of the cecum and part of the ileocecal region. It arises in the right lower quadrant and courses behind the cecum, running between the layers of the mesentery toward the posteromedial cecal wall.

This artery, along with the anterior cecal artery, ensures robust perfusion of the cecum and contributes to the vascular arcade surrounding the ileocecal region. It is clinically relevant in appendiceal surgery, right hemicolectomy, and ischemic bowel evaluation, as well as in imaging interpretation of cecal wall thickening.

Synonyms

  • Posterior branch of the cecal artery

  • Dorsal cecal artery

Origin, Course, and Termination

Origin:

  • Arises from the ileocolic artery, which is the lowest branch of the superior mesenteric artery (SMA).

Course:

  • Passes posterior to the cecum, usually running along its medial or posteromedial wall

  • Travels within the ileocecal mesentery (mesocecum)

Termination:

  • Forms small branches that spread across the posterior cecal wall

  • May anastomose with:

    • Anterior cecal artery

    • Appendicular artery

    • Small branches from right colic or ileal arteries

Relations

  • Anteriorly: Cecum

  • Posteriorly: Retrocecal fat, retroperitoneal fascia

  • Medially: Ileocecal junction and terminal ileum

  • Laterally: Lateral cecal wall and paracolic gutter

  • Inferiorly: Base of appendix (in some anatomic variants)

Function

  • Supplies arterial blood to the posterior wall of the cecum

  • Contributes to the ileocecal arterial arcade

  • Helps maintain perfusion of the cecum during positional changes, distention, or surgical manipulation

MRI Appearance

T1-weighted images:

  • Normal flowing blood shows a dark flow void within the artery

  • Surrounding mesenteric fat appears bright, clearly outlining the vessel

  • Cecal wall shows intermediate signal with smooth layering patterns

T2-weighted images:

  • Artery remains a dark tubular structure due to flow void

  • Mesenteric fat is bright, enhancing vessel conspicuity

  • Cecal wall demonstrates intermediate-to-bright signal depending on mucosal hydration

STIR:

  • Flowing blood remains dark

  • Fat suppression highlights the artery as a low-signal channel in a dark background

  • Useful for identifying vessel course within the mesentery

T1 Fat-Saturated Post-Contrast:

  • Artery fills with bright, homogeneous contrast enhancement

  • Cecal wall enhances moderately and smoothly

  • Enhancing vessel clearly visualized against suppressed mesenteric fat

CT Appearance

Non-Contrast CT:

  • Artery appears as a small soft-tissue attenuation structure within the mesocecum

  • Surrounding fat allows identification of the vessel pathway

  • Cecal wall remains smooth with uniform density

Post-Contrast CT:

  • The posterior cecal artery enhances as a small bright vascular branch arising from the ileocolic artery

  • Best visualized in arterial-phase CT with thin-slice reconstructions

  • Forms part of the vascular network on the posterior aspect of the cecum

MRI image

Posterior Cecal Artery MRI coronal image-img-00000-00000