Ileocecal valve

Microanatomy

The histology of the ileocecal valve shows an abrupt change from a villous mucosa pattern of the ileum to a more colonic mucosa. A thickening of the muscularis mucosa, which is the smooth muscle tissue found beneath the mucosal layer of the digestive tract. A thickening of the muscularis externa is also noted.

There is also a variable amount of lymphatic tissue found at the valve.

The ileocecal valve has a papillose structure.

Clinical significance

Colonoscopy

During colonoscopy, the ileocecal valve is used, along with the appendiceal orifice, in the identification of the cecum. This is important as it indicates that a complete colonoscopy has been performed. The ileocecal valve is typically located on the last fold before entry into the cecum and can be located from the direction of curvature of the appendiceal orifice, in what is known as the bow and arrow sign.

Intubation of the ileocecal valve is typically performed in colonoscopy to evaluate the distal, or lowest, part of the ileum. Small bowel endoscopy can also be performed by double-balloon enteroscopy through intubation of the ileocecal valve.

Lesions

Tumors of the ileocecal valve are rare, but have been reported in the literature. Other benign lesions may also occur on the ileocecal valve, which are often hard to diagnose and treat surgically.

History

The ileocecal valve was described by the Dutch physician Nicolaes Tulp (1593–1674), and thus it is sometimes known as Tulp's valve.

The ileocecal valve was also described in 1588 by Gaspard Bauhin—hence the name Bauhin's Valve or Valve of Bauhin—in the preface of his first writing, De corporis humani partibus externis tractatus, hactenus non editus.

Additional images

File:Ileum, cecum and ascending colon.JPG|Ileum, cecum and ascending colon File:Cecum and ileum.JPG|Cecum and ileum File:Ileo-cecal valve.JPG|Ileo-cecal valve File:Cecum and ileum 3.JPG|Ileo-cecal valve

References

Explanatory notes

Citations

References

1. (2012). "The human ileocaecal junction: anatomical evidence of a sphincter". Surgical and Radiologic Anatomy.
2. Barret KE. "Lange Gastrointestinal Physiology". The McGraw-Hill Companies, 2006.
3. Burkitt HG, Young B, Heath JW. ''Wheater's Functional Histology'': a text and colour atlas. Churchill Livingstone, London, 1993.
4. Cotton PB, Williams CB. ''Practical Gastrointestinal Endoscopy'' Blackwell Publishers, London, 1996
5. (2005). "Balloon-assisted intubation of the ileocecal valve to facilitate retrograde double-balloon enteroscopy". Gastrointestinal Endoscopy.
6. (2004). "Adenocarcinoma of the ileocecal valve: report of a case". The Turkish Journal of Gastroenterology.
7. (2005). "Isolated ileocecal lymphoma". Gastrointestinal Endoscopy.
8. (1955-01-01). "Ileocecal Valve Syndrome". Gastroenterology.