Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Sep 25;7(13):1103-6.
doi: 10.4253/wjge.v7.i13.1103.

Triradiate caecal fold: Is it a useful landmark for caecal intubation in colonoscopy?

Andrew Finlayson  1 , Raaj Chandra  1 , Ian A Hastie  1 , Ian T Jones  1 , Susan Shedda  1 , Michael K-Y Hong  1 , Aileen Yen  1 , Ian P Hayes  1
Affiliations

Triradiate caecal fold: Is it a useful landmark for caecal intubation in colonoscopy?

Andrew Finlayson et al. World J Gastrointest Endosc. .

Abstract

Aim: To determine the frequency of identification of the triradiate fold during colonoscopy and evaluate its reliability as a marker of caecal intubation.

Methods: One hundred consecutive patients undergoing colonoscopy in a tertiary hospital colorectal unit from May to September 2013 were studied. Video documentation of the caecum was recorded and shown to consultant colorectal surgeons on the unit. Each reviewer was asked through a series of questions to independently identify the triradiate fold. The main outcome was the frequency of visualisation of the triradiate fold in the caecum.

Results: The triradiate fold was seen on average in 18% of cases, but inter-observer agreement was poor. There were only four patients (4%) in which all reviewers agreed on the presence of a triradiate fold. In patients who had undergone previous appendicectomy, the appendiceal orifice was less frequently seen compared with patients who had not undergone appendicectomy.

Conclusion: The triradiate fold is infrequently seen during colonoscopy and is therefore an unreliable landmark of caecal intubation.

Keywords: Appendiceal orifice; Caecal intubation; Colonoscopy; Prospective study; Triradiate fold.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Photograph of a triradiate fold converging on the appendiceal orifice.
Figure 2
Figure 2
Photograph of an appendiceal orifice with no converging triradiate fold.
See this image and copyright information in PMC

References

    1. Cirocco WC, Rusin LC. Confirmation of cecal intubation during colonoscopy. Dis Colon Rectum. 1995;38:402–406. - PubMed
    1. Clark , Rocker , Reddy , Aslam , Owen Confirmation of complete colonoscopy without intubation of the ileum. Colorectal Dis. 1999;1:283–285. - PubMed
    1. Coe SG, Panjala C, Heckman MG, Patel M, Qumseya BJ, Wang YR, Dalton B, Tran P, Palmer W, Diehl N, et al. Quality in colonoscopy reporting: an assessment of compliance and performance improvement. Dig Liver Dis. 2012;44:660–664. - PubMed
    1. Park HJ, Hong JH, Kim HS, Kim BR, Park SY, Jo KW, Kim JW. Predictive factors affecting cecal intubation failure in colonoscopy trainees. BMC Med Educ. 2013;13:5. - PMC - PubMed
    1. Rex DK. Still photography versus videotaping for documentation of cecal intubation: a prospective study. Gastrointest Endosc. 2000;51:451–459. - PubMed

LinkOut - more resources