New concept of ileocecal junction: Intussusception of the terminal ileum into the cecum

Awapittaya, Burin; Tansatit, Tanwa; Kanjanasilpa, Prapon; Sahakijrungruang, Chucheep; Rojanasakul, Arun

doi:10.3748/wjg.v13.i20.2855

Cited by 8 publications

(4 citation statements)

References 6 publications

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“…The most predominantly seen morphological type of ICV in our study was type II C, followed by classical and the least common types of ICV were type IVA, IVB, and V. This finding of the present study was like the findings of Kellogg (1914) and Short A (1919), who found that the most common type of ICV was valvular with variations followed by papillary and lipomatous [ 8 , 17 ]. Conversely, our findings contradict the findings of Buirge (1943) and Awapittaya (2007) who observed that the most common morphological type of ICV was type I, and type IIC was the least common type [ 16 , 18 ]. In all three cases of fetal autopsy studied, ICJ had reverse-S morphology and the most common morphological type of ICV was papillary type.…”

Section: Discussioncontrasting

confidence: 99%

Assessment of Anatomical Morphology of the Ileocecal Junction and Ileocecal Valve by Dissection and Endoscopy

Manoj,

Paul

2024

Cureus

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Introduction: The ileocecal valve (ICV) guards the opening of the ileocecal junction (ICJ) and acts as a mechanical barrier to prevent the reflux of material from the colon into the ileum. The morphology of the ICV noted in living is different from that of cadavers. The ICV is better studied in the living by endoscopy. A study of variation in the gross anatomy of the ICV can help determine the factors responsible for its competency.Materials and methods: A descriptive study was conducted on a total of 85 (N) patients each in two groups over a period of two years. Group I: 85 specimens of the ileocecal region obtained during dissection; Group 2: 85 patients undergoing colonoscopic study undertaken in the Department of Medical Gastroenterology. In the dissection method, the apparently normal ICJ was inspected, photographed, and measured using Vernier calipers. In the colonoscopy method, the procedure was observed and while observing ICV, photos were taken. These photographs were later compared with other photographs in the literature to identify the morphology of ICV. The age, gender, location, and morphology of ICV were represented in percentile, and qualitative variables were analyzed by Pearson correlation coefficient.Results: Out of 85 participants in Group A, 80% (68) were males and 20% (17) were females; in Group B, 58% (49) were males, and the remaining 42% (36) were females. In the dissection method out of 85 (N) patients, 98% had reverse S type terminal ileum, correlation of diameter of ICV with age p=0.003 and correlation of morphology of ICV with age p=0.006, and was statistically significant. In the colonoscopy method, 58% were males and 22% of them were 31-40 years. In 49% of patients, ICV was viewed from the left lateral position. The correlation of success of ileoscopy with age (p=0.608), gender (p=0.896), the position of the patient (p=0.236), and morphology of ICV (p=0.631) was not statistically significant.Conclusion: There were no age-related changes observed regarding the morphology of the ICJ. It was found that as age increases diameter of ICV increases. The success of ileoscopy was highest in 31-40 years of age.

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Section: Discussioncontrasting

confidence: 99%

Assessment of Anatomical Morphology of the Ileocecal Junction and Ileocecal Valve by Dissection and Endoscopy

Manoj,

Paul

2024

Cureus

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“…The anatomy and neuroanatomy of the ileocecal junction showed in our study suggest that the ileocecal junction is a simple intussusception of the ileum into the cecum, which is in accordance with the latest concept of the ICV: intussusception of the terminal ileum into the cecum (Awapittaya et al, 2007). The designs of previous techniques suggested for ICV replacement are not close to the original layout of the normal ileocecal junction (Fig.…”

Section: Discussionsupporting

confidence: 78%

New Insights into the Neuromuscular Anatomy of the Ileocecal Valve

Cserni

Paran

Kanyári

et al. 2008

The Anatomical Record

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The neuroanatomy of the ileocecal valve (ICV) is poorly understood. A better understanding of this important functional component of the gastrointestinal tract would enable surgeons to reconstruct an effective valve following surgical resection of the ICV. ICVs were examined in young pigs (N 5 5) using frontal and transverse paraffin embedded and frozen sections. Hematoxylin1Eosin (H1E) staining, acetylcholinesterase (AchE), and NADPH-diaphorase (NADPH-d) histochemistry and protein gene product 9.5 (PGP 9.5) and C-kit immunohistochemistry were performed. The H1E staining revealed that the ICV consists of three muscle layers: an external circular muscle layer continuous with that of the ileal circular muscle layer, an inner circular muscle layer continuous with that of the cecal circular muscle layer, and a single longitudinal muscle layer, which appears to be secondary to a fusion of the ileal and cecal longitudinal muscle layers. The AchE, NADPH-d, and PGP 9.5 staining revealed two distinct coaxial myenteric plexuses, together with superficial and deep submucosal plexuses. The C-kit immunostaining showed a continuous myenteric ICC network within the ICV. The structure of the neuromuscular components within the ICV suggests that the valve is a result of a simple intussusception of the terminal ileum into the cecum. This knowledge may help surgeons in their future attempts at reconstructing more anatomically and functionally suitable ICVs following surgical resection of native ICVs.

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“…Although Awapittaya et al (2007) have concluded that the ileocaecal valve is a simple intussusception of the terminal ileum into the caecum on the basis of its gross anatomy and the microscopic observations of human specimens, the structural characteristics of the ileocaecal junction remain obscure. These include the organization of muscle bundles in the terminal ileum, their continuity with those of the ileum or caecum, the characteristics of the intrinsic nerve plexus, the presence or absence of the interstitial cells of Cajal (ICC) and the existence of any specialized structures forming the valve.…”

Section: Introductionmentioning

confidence: 99%

Distribution and morphological characteristics of the interstitial cells of Cajal in the ileocaecal junction of the guinea-pig

2009

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The guinea-pig ileocaecal junction including the valve was studied by immunohistochemistry to clarify the organization of the muscle bundles, the enteric nerves and the interstitial cells of Cajal (ICC). This region clearly exhibited characteristic features in the distribution patterns of ICC in a proximal to distal direction: (1) the thickened portion of the terminal ileum immediately adjacent to the ileocecal junction contained many ICC throughout the circular (ICC-CM) and longitudinal (ICC-LM) muscle layers, but ICC were few or absent in the rest of the ileum; (2) the ileal side of the valve contained ICC associated with the deep muscular plexus (ICC-DMP) as in the small intestine, whereas ICC-DMP were absent in the caecal side as in the caecum; (3) the valve contained many ICC-CM and ICC-LM in both the ileal and caecal sides; (4) many ICC associated with the myenteric plexus were observed in both the ileal and caecal sides of the valve, whereas they were only sparsely found in the caecum; (5) ICC were also observed around the submucosal plexus in a confined area of the terminal ileum and the ileocaecal valve. These observations provide morphological evidence that the terminal ileum and ileocaecal valve are specially equipped for their active involvement in the movement of the junctional area.

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New concept of ileocecal junction: Intussusception of the terminal ileum into the cecum

Cited by 8 publications

References 6 publications

Assessment of Anatomical Morphology of the Ileocecal Junction and Ileocecal Valve by Dissection and Endoscopy

Assessment of Anatomical Morphology of the Ileocecal Junction and Ileocecal Valve by Dissection and Endoscopy

New Insights into the Neuromuscular Anatomy of the Ileocecal Valve

Distribution and morphological characteristics of the interstitial cells of Cajal in the ileocaecal junction of the guinea-pig

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