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Ileocecal junction: anatomic, histologic, radiologic and endoscopic studies with special reference to its antireflux mechanism

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Abstract

Aim

The aim of the study was to perform histomorphologic, endoscopic, and radiologic studies of the ileocecal junction (ICJ). A clearer understanding of the anatomical structure of the ICJ may shed some light on its function.

Methods

Histomorphologic studies were performed in 18 cadavers and radiologic in 22 and endoscopic in 10 healthy volunteers. Morphologic studies were done with the help of a magnifying loupe: histologic sections were stained with hematoxylin and eosin and Masson’s trichrome. The ICJ was studied radiologically using the method of small bowel meal. Endoscopic study was done under controlled air inflation using a video endoscope.

Results

A nipple (1.5–2 cm long) with transversely lying stoma protruded from the medial wall of the cecum. A fornix was found on each side. The nipple stoma was surrounded by two lips: upper and lower. A mucosal fold started at both angles of the stoma and extended along the cecal circumference. It was marked on the outer cecal aspect by a groove.

Conclusion

The ileocecal nipple is a muscular tube with a transversely lying stoma and is suspended to the cecal wall by a “suspensory ligament”. The morphologic structure of the ileocecal nipple was confirmed endoscopically and radiologically. The ileocecal nipple was closed at rest and opened upon terminal ileal contraction to deliver ileal contents to the cecum. It evacuated the barium periodically into the cecum. The ileocecal nipple structure seems to be adapted to serve the function of cecoileal antireflux.

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Abbreviations

ICJ:

Ileocecal junction

ICN:

Ileocecal nipple

IC:

Ileocecal

SD:

Standard deviation

References

  1. Boggers JJ, Van Mark E (1993) The ileocecal junction. Histol Histopathol 8:561–566

    Google Scholar 

  2. Calabuig R, Weems WA, Moody FG (1996) Ileo-cecal junction: a valve or a sphincter? An experimental study in the opossum. Rev Esp Enfer Dig 88:828–839

    CAS  Google Scholar 

  3. Flourie B, Phillips S, Azpiroz F (1989) Cyclic motility in canine colon: responses to feeding and perfusion. Dig Dis Sci 34:1185–1192

    Article  PubMed  CAS  Google Scholar 

  4. Gorbach SL, Plant AG, Nahas L, Weinstein L, Spanknebel G, Levitan R (1967) Studies of intestinal microflora. II. Microorganisms of the small intestine and their relationship to oral and fecal flora. Gastroenterology 53:856–867

    PubMed  CAS  Google Scholar 

  5. Hoffmann R, Gomez R, Tanagho EA (1993) Motility and intraluminal pressure of the ileocolonic junctional zone and adjacent bowel in a canine model. Urol Res 21:329–332

    Article  Google Scholar 

  6. Kajimoto T, Dinning PG, Gibb DB, de Carle DJ, Cook IJ (2000) Neurogenic pathways mediating ascending and descending reflexes at the porcine ileocolonic junction. Neurogastroenterol Motil 12:125–134

    Article  PubMed  CAS  Google Scholar 

  7. Kellogg VL (1913) Ecto-parasites of the monkeys, apes and man. Science 24:601–602

    Article  Google Scholar 

  8. Mizhorkova Z, Kortezova N, Bredy-Dobreva G (1994) Role of nitric oxide in mediating non-adrenergic non-cholinergic relaxation of the cat ileocecal sphincter. Eur J Pharmacol 265:77–82

    Article  PubMed  CAS  Google Scholar 

  9. Phillips SF, Giller J (1973) The contribution of the colon to electrolyte and water conservation in man. J Lab Clin Med 81:733–746

    PubMed  CAS  Google Scholar 

  10. Quigley EM (1988) Motor activity of the distal ileum, ileocecal sphincter and its relation to the region’s function. Dig Dis 6:229–241

    Article  PubMed  CAS  Google Scholar 

  11. Quigley EMM, Phillips SF, Cranley B, Taylor BM (1985) Tone of canine ileocolonic junction: topography and response to phasic contractions. Am J Physiol 249:G350–G357

    PubMed  CAS  Google Scholar 

  12. Quigley EM, Phillips SF, Dent J, Taylor BM (1983) Myoelectric activity and intraluminal pressure of the canine ileocolonic sphincter. Gastroenterology 85:1054–1062

    PubMed  CAS  Google Scholar 

  13. Sarna SK (1991) Physiology and pathophysiology of colonic motor activity. Dig Dis Sci 36:998–1018

    Article  PubMed  CAS  Google Scholar 

  14. Snell RS (1995) The abdominal cavity. In: Snell RS (ed) Clinical anatomy for medical studies, 5th edn. Little, Brown & Co., Boston, pp 183–244

    Google Scholar 

  15. Sutton D (1990) The small bowel. In: Sutton D (ed) A textbook of radiology and imaging, 4th edn. Churchill Livingstone, Edinburgh, pp 863–903

    Google Scholar 

  16. Ulin AW, Deutsch J (1950) Visualization of ileocecal papilla in a living subject. Gastroenterology 16(2):444–449

    PubMed  CAS  Google Scholar 

Download references

Acknowledgment

Margot Yehia assisted in preparing the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt

    Ali A. Shafik, Ismail A. Ahmed & Ahmed Shafik

  2. Department of Anatomy, Faculty of Medicine, Cairo University, Cairo, Egypt

    Mohamed Wahdan

  3. Department of Histology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Soheir Asaad

  4. Department of Tropical Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

    Essam El Neizamy

  5. Ahmed Shafik Hospital, 7, Gamal Salem St., of Mossadek St., Dokki-Giza, 12311, Egypt

    Ali A. Shafik

Authors
  1. Ali A. Shafik
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  2. Ismail A. Ahmed
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  3. Ahmed Shafik
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  4. Mohamed Wahdan
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  5. Soheir Asaad
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  6. Essam El Neizamy
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Correspondence to Ali A. Shafik.

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Shafik, A.A., Ahmed, I.A., Shafik, A. et al. Ileocecal junction: anatomic, histologic, radiologic and endoscopic studies with special reference to its antireflux mechanism. Surg Radiol Anat 33, 249–256 (2011). https://doi.org/10.1007/s00276-010-0762-x

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  • DOI: https://doi.org/10.1007/s00276-010-0762-x

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