Pulled up caecum is a feature of?

**Core Concept**
Pulled up caecum is a clinical sign associated with intestinal obstruction, specifically ileocaecal intussusception, where a part of the intestine invaginates into another part, causing the caecum to be pulled upwards.

**Why the Correct Answer is Right**
Ileocaecal intussusception occurs when a part of the ileum invaginates into the caecum, leading to obstruction and the characteristic pulled-up caecum. This condition can cause severe abdominal pain, vomiting, and constipation. The invagination of the ileum into the caecum can be visualized on imaging studies such as X-rays or CT scans.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because pulled-up caecum is not a feature of sigmoid volvulus, which is a different type of intestinal obstruction that occurs when the sigmoid colon twists around its mesenteric axis.

**Option B:** This option is incorrect because pulled-up caecum is not a feature of cecal cancer, which may cause a mass in the right lower quadrant but does not typically cause the caecum to be pulled upwards.

**Option C:** This option is incorrect because pulled-up caecum is not a feature of appendicitis, which typically presents with right lower quadrant pain and tenderness.

**Clinical Pearl / High-Yield Fact**
In cases of suspected intestinal obstruction, a pulled-up caecum on abdominal X-ray can be a critical diagnostic clue, prompting further investigation with imaging studies or surgical intervention.

**Correct Answer: C.**