Periaqueductal nodularity is an imaging descriptor that usually refers to the presence of enlarged lymph nodes that require prompt medical attention. Because of the large number of lymph nodes in this area, this condition is most commonly associated with infections of the ileocecal region, such as appendicitis, or enlarged abdominal lymph nodes due to respiratory infections in children, or lymphatic metastases from malignant tumors in the abdominal or pelvic cavity. Nodular shadows around the ileocecal region are more likely to be caused by lymphadenitis or enlarged lymph nodes, and are usually associated with infectious factors, such as viral or bacterial colds or infections, and are likely to occur when the body’s resistance is relatively low, and should be diagnosed in conjunction with symptoms such as abdominal pain, size of the appendix, and the need to check the intestinal tract and the abdominal and pelvic cavity for tumors if necessary. If the nodular shadow around the ileocecal region is found, the examination should be further improved, and the diagnosis should be clarified and correct treatment should be given in time.