Ileocecal valve | |
---|---|
Details | |
System | Digestive system |
Location | Junction between ileum and cecum |
Artery | Ileocolic artery |
Vein | Ileocolic vein |
Function | Muscular sphincter |
Identifiers | |
Latin | valva ileocaecalis s. papilla ilealis |
MeSH | D007080 |
FMA | 15973 |
Anatomical terminology |
The ileocecal valve (ileal papilla, ileocaecal valve, Tulp's valve, Tulpius valve, Bauhin's valve, ileocecal eminence, valve of Varolius or colic valve) is a sphincter muscle valve that separates the small intestine and the large intestine. [1] Its critical function is to limit the reflux of colonic contents into the ileum. [2] Approximately two liters of fluid enters the colon daily through the ileocecal valve.
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,[ citation needed ] which is the smooth muscle tissue found beneath the mucosal layer of the digestive tract. A thickening of the muscularis externa is also noted. [1]
There is also a variable amount of lymphatic tissue found at the valve. [3]
The ileocecal valve has a papillose structure.
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. [4]
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. [5]
Tumors of the ileocecal valve are rare, but have been reported in the literature. [6] [7] Other benign lesions may also occur on the ileocecal valve, which are often hard to diagnose and treat surgically. [8]
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.
The gastrointestinal tract is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as faeces. Gastrointestinal is an adjective meaning of or pertaining to the stomach and intestines.
The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In mammals it may be the principal site for iron absorption. The duodenum precedes the jejunum and ileum and is the shortest part of the small intestine.
The cecum or caecum is a pouch within the peritoneum that is considered to be the beginning of the large intestine. It is typically located on the right side of the body. The word cecum stems from the Latin caecus meaning blind.
The ileum is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms posterior intestine or distal intestine may be used instead of ileum. Its main function is to absorb vitamin B12, bile salts, and whatever products of digestion that were not absorbed by the jejunum.
The small intestine or small bowel is an organ in the gastrointestinal tract where most of the absorption of nutrients from food takes place. It lies between the stomach and large intestine, and receives bile and pancreatic juice through the pancreatic duct to aid in digestion. The small intestine is about 5.5 metres long and folds many times to fit in the abdomen. Although it is longer than the large intestine, it is called the small intestine because it is narrower in diameter.
The appendix is a finger-like, blind-ended tube connected to the cecum, from which it develops in the embryo. The cecum is a pouch-like structure of the large intestine, located at the junction of the small and the large intestines. The term "vermiform" comes from Latin and means "worm-shaped". The appendix was once considered a vestigial organ, but this view has changed since the early 2000s. Research suggests that the appendix may serve an important purpose as a reservoir for beneficial gut bacteria.
In medicine (gastroenterology), angiodysplasia is a small vascular malformation of the gut. It is a common cause of otherwise unexplained gastrointestinal bleeding and anemia. Lesions are often multiple, and frequently involve the cecum or ascending colon, although they can occur at other places. Treatment may be with colonoscopic interventions, angiography and embolization, medication, or occasionally surgery.
A Meckel's diverticulum, a true congenital diverticulum, is a slight bulge in the small intestine present at birth and a vestigial remnant of the vitelline duct. It is the most common malformation of the gastrointestinal tract and is present in approximately 2% of the population, with males more frequently experiencing symptoms.
Gastrointestinal diseases refer to diseases involving the gastrointestinal tract, namely the esophagus, stomach, small intestine, large intestine and rectum, and the accessory organs of digestion, the liver, gallbladder, and pancreas.
Lower gastrointestinal bleeding, commonly abbreviated LGIB, is any form of gastrointestinal bleeding in the lower gastrointestinal tract. LGIB is a common reason for seeking medical attention at a hospital's emergency department. LGIB accounts for 30–40% of all gastrointestinal bleeding and is less common than upper gastrointestinal bleeding (UGIB). It is estimated that UGIB accounts for 100–200 per 100,000 cases versus 20–27 per 100,000 cases for LGIB. Approximately 85% of lower gastrointestinal bleeding involves the colon, 10% are from bleeds that are actually upper gastrointestinal bleeds, and 3–5% involve the small intestine.
Double-balloon enteroscopy, also known as push-and-pull enteroscopy, is an endoscopic technique for visualization of the small bowel. It was developed by Hironori Yamamoto in 2001. It is novel in the field of diagnostic gastroenterology as it is the first endoscopic technique that allows for the entire gastrointestinal tract to be visualized in real time.
The bow and arrow sign is an endoscopic sign for determining the location of the ileocecal valve during colonoscopy. Identifying the ileocecal valve in a colonoscopy is important, as it indicates that the entire colon has been visualized.
Capsule endoscopy is a medical procedure used to record internal images of the gastrointestinal tract for use in disease diagnosis. Newer developments are also able to take biopsies and release medication at specific locations of the entire gastrointestinal tract. Unlike the more widely used endoscope, capsule endoscopy provides the ability to see the middle portion of the small intestine. It can be applied to the detection of various gastrointestinal cancers, digestive diseases, ulcers, unexplained bleedings, and general abdominal pains. After a patient swallows the capsule, it passes along the gastrointestinal tract, taking a number of images per second which are transmitted wirelessly to an array of receivers connected to a portable recording device carried by the patient. General advantages of capsule endoscopy over standard endoscopy include the minimally invasive procedure setup, ability to visualize more of the gastrointestinal tract, and lower cost of the procedure.
Chromoendoscopy is a medical procedure wherein dyes are instilled into the gastrointestinal tract at the time of visualization with fibre-optic endoscopy. The purposes of chromoendoscopy is chiefly enhance the characterization of tissues, although dyes may be used for other functional purposes. The detail achieved with chromoendoscopy can often allow for identification of the tissue type or pathology based upon the pattern uncovered.
Blair S. Lewis, M.D., F.A.C.P., F.A.C.G., is an American board-certified gastroenterologist and Clinical Professor of Medicine at the Mount Sinai School of Medicine. Lewis is a specialist in the field of gastrointestinal endoscopy and was the primary investigator for the first clinical trial of capsule endoscopy for the small intestine and also the first clinical trial of capsule endoscopy for the colon.
The human digestive system consists of the gastrointestinal tract plus the accessory organs of digestion. Digestion involves the breakdown of food into smaller and smaller components, until they can be absorbed and assimilated into the body. The process of digestion has three stages: the cephalic phase, the gastric phase, and the intestinal phase.
Duodenal lymphocytosis, sometimes called lymphocytic duodenitis, lymphocytic duodenosis, or duodenal intraepithelial lymphocytosis, is a condition where an increased number of intra-epithelial lymphocytes is seen in biopsies of the duodenal mucosa when these are examined microscopically. This form of lymphocytosis is often a feature of coeliac disease but may be found in other disorders.
Colonic ulcer can occur at any age, in children however they are rare. Most common symptoms are abdominal pain and hematochezia.
Biliary endoscopic sphincterotomy is a procedure where the sphincter of Oddi and the segment of the common bile duct where it enters the duodenum are cannulated and then cut with a sphincterotome, a device that includes a wire which cuts with an electric current (electrocautery).